Nevin Manimala

Orphanet J Rare Dis. 2025 Jun 21;20(1):316. doi: 10.1186/s13023-025-03786-1.

ABSTRACT

BACKGROUND: Ataxia-telangiectasia (A-T) is an inherited multiorgan disorder with onset in childhood. Liver involvement, with steatosis and subsequent fibrosis, is increasingly recognized in children and young people with A-T.

PURPOSE: To evaluate feasibility of T1-weighted two-point mDixon MRI for identification of liver steatosis in children with A-T and conduct exploratory analysis of relationships between MRI-quantified liver fat fraction and clinical and laboratory measures.

STUDY TYPE: Post hoc analysis of prospectively collected research data.

POPULATION: 16 participants (8 female) with A-T aged 4.8-16.6 years.

FIELD STRENGTH/SEQUENCE: 3.0-T, two-point T1-weighted mDixon.

ASSESSMENT: Participants underwent whole-body MRI including T1-weighted mDixon. Water/fat signal percentage images were generated. Hepatic T1 fat fraction (T1-FF) was calculated from regions-of-interest placed in the right anterior, right posterior and left hepatic lobes. T1-FF > 5.56% was used as the diagnostic criterion for hepatic steatosis.

STATISTICAL TESTS: Group comparisons of variables between participants with and without previous diagnosis of liver steatosis were made using independent sample Mann-Whitney U. Associations between T1-FF and age, neurological severity and of liver function tests were tested with Spearman correlation. Statistical significance was pre-specified as p < 0.05.

RESULTS: Analyzable T1-weighted mDixon data was available for 11 participants. Five MRI datasets were discarded due to motion artefact (n = 3) or incorrect archiving of the original water image (n = 2). Median liver T1-FF was 11.3% (4.7-49.7%), and 10/11 (91%) of participants had evidence of steatosis. Participants with previous diagnosis of steatosis had higher T1-FF than those without (median 32.7% [9.7-49.7%], versus 10.3% [4.7-11.3%], p = 0.030). T1-FF correlated most strongly with alanine transaminase (r = 0.76, p = 0.007) and γ-glutamyltransferase (r = 0.76, p = 0.006).

CONCLUSION: T1-weighted mDixon MRI is feasible for detecting steatosis in children with A-T, although motion artefacts reduced data completeness. MRI-quantified liver T1-FF correlates with markers of liver health. We found higher prevalence of liver steatosis using T1-weighted mDIXON than previously reported in pediatric A-T cohorts.

PMID:40542396 | DOI:10.1186/s13023-025-03786-1

J Neurodev Disord. 2025 Jun 20;17(1):34. doi: 10.1186/s11689-025-09626-4.

ABSTRACT

OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder with a significant genetic component. The latest genome-wide association study (GWAS) meta-analysis of ADHD identified 27 whole-genome significant risk loci in the European population. However, genetic risk factors for ADHD are less well-characterized in the Asian population, especially for low-frequency / rare variants.

METHODS: In this study, we aimed to investigate the contributions of both common and low-frequency / rare variants to ADHD in a Hong Kong sample. Our sample comprised 279 cases and 432 controls who underwent genotyping using the Illumina Infinium Global Screening Array. We employed various analytical methods at different levels, while also leveraging multi-omics data and large-scale summary statistics to comprehensively analyze the genetic basis of ADHD.

RESULTS: We identified 41 potential genomic risk loci with a suggestive association (p < 1e^-4), pointing to 111 candidate risk genes, which were enriched for genes differentially expressed during late infancy brain development. Furthermore, tissue enrichment analysis implicated the involvement of the cerebellum. At the polygenic level, we also discovered a strong genetic correlation with resting-state functional MRI connectivity of the cerebellum involved in the attention/central executive and subcortical-cerebellum networks. In addition, an accumulation of ADHD common-variant risks found in European ancestry samples was found to be significantly associated with ADHD in the current study. In low-frequency / rare variant analyses, we discovered the correlations between ADHD and collapsing effects of rare damaging variants in TEP1, MTMR10, DBH, TBCC, and ANO1. Based on biological and functional profiles of the potential risk genes and gene sets, both common and low-frequency / rare variant analyses demonstrated that ADHD genetic risk was associated with immune processes.

CONCLUSIONS: These findings re-validate the abnormal development of the neural system in ADHD and extend the existing neuro-dysfunction hypothesis to a multi-system perspective. The current study identified convergent risk factors from common and low-frequency / rare variants, which implicates vulnerability in late-infancy brain development, affecting especially the cerebellum, and the involvement of immune processes.

PMID:40542392 | DOI:10.1186/s11689-025-09626-4

Popul Health Metr. 2025 Jun 20;23(Suppl 2):28. doi: 10.1186/s12963-025-00387-9.

ABSTRACT

BACKGROUND: Before COVID-19, knowledge on pandemic vulnerability and mortality in South Africa was largely limited to the context of HIV/AIDS. We evaluated mortality rates and risk of death, prior to and during the COVID-19 pandemic, in relation to an individual’s COVID-19 vulnerability, based on a scoring algorithm developed in South Africa.

METHODS: The analysis was undertaken using data from a health and demographic surveillance system (HDSS) in Soweto and Thembelihle, Gauteng, South Africa. Health and demographic population-based data have been collected from the HDSS area since 2018. Using indicators included in a COVID-19 Vulnerability Index, previously developed in South Africa, the current study established a composite COVID-19 vulnerability index, stratified into tertiles. The risk of death pre-COVID-19 (1 January 2018-28 February 2020) and during the COVID-19 period (1 March 2020-31 December 2021) was analysed. A Cox proportional hazard model was used to compare the risk of death between the two time periods. Statistical analyses were conducted using Stata software version 17.

RESULTS: Before COVID-19, overall mortality rates were 8.1 (95% CI 7.6-8.8), 7.0 (95% CI 6.4-7.7) and 6.1 (95% CI 5.5-6.7) per 1000 person-years in the lowest, middle, and highest tertile of vulnerability index, respectively. All cause-mortality across all tertiles more than doubled during the COVID-19 period compared to pre-COVID-19 (15.5 against 7.2). The mortality rates during the COVID-19 era were 17.1 (95% CI 16.3-18.0), 14.5 (95% CI 13.4-15. 7) and 13.7 (95% CI 12.8-14.7) per 1000 person-years in the lowest, middle, and highest tertiles, respectively. Overall, individuals in the highest tertile of COVID-19 vulnerability were at a significantly lower risk of death relative to those in the lowest tertile (aHR 0.9, 95% CI 0.8-1.0, p < 0.05). The risk of dying during the COVID-19 period for vulnerable individuals was at least double compared to the pre-COVID-19 period for each of the individual vulnerability indicators.

CONCLUSIONS: All-cause mortality during the COVID-19 era was significantly higher than the pre- COVID-19 period, with the increase observed across all vulnerability tertiles. It is important to identify vulnerable individuals and communities during the early stages of a pandemic to inform prioritisation of public health intervention.

PMID:40542376 | DOI:10.1186/s12963-025-00387-9

BMC Nurs. 2025 Jun 20;24(1):662. doi: 10.1186/s12912-025-03301-8.

ABSTRACT

BACKGROUND: Nurses’ intention to leave harms healthcare organizations and the nursing profession. Organizational productivity level that cannot be achieved without their attention to improving nurses’ loyalty with quiet firing management and nurses’ quiet quitting.

PURPOSE: This study aims to examine the relationships between nurses’ loyalty, intention to leave, quiet quitting, and quiet firing. Also, investigate the role of quiet quitting in the relation between nurses’ quiet firing, loyalty, and intention to leave.

METHODS: The study employed a cross-sectional design. Data were collected from nurses in Sohag University Hospital, Egypt. It was conducted with 482 nurses who had worked at their employing facility. Researcher used three scales; intention to leave scale, loyalty scale and quiet quitting and quiet firing scale.

RESULTS: Shows that there was a high statistically significant (P < 0.001) positive correlation between quiet quitting intention and perceived quiet firing (r = 0.460**), quiet quitting intentions and intention to leave scale (r = 0.464^**), perceived quiet firing and intention to leave scale (r = 0.450^**), while there was a statistically significant negative correlation between nurses’ loyalty and quiet quitting and quiet firing scale at (r = -0.300^**) and nurses’ loyalty and intention to leave scale at (r =-0.186^**).

CONCLUSION: The research findings concluded that there was a highly statistically significant relation between quiet quitting intentions, perceived quiet firing, nurse loyalty, and intention to leave. Also, there was a statistically significant indirect effect of perceived quiet firing on nurses’ intention to leave and perceived quiet firing on nurses’ loyalty when the perceived quiet firing acted as a mediator variable.

IMPLICATIONS FOR NURSING AND HEALTH POLICY: Policy implications to increase nurses’ loyalty by increasing nursing participation in hospital committees, promotion opportunities, implementation of professional practice models, and use of mentorship programs, to competitive compensation and career development opportunities.

PMID:40542367 | DOI:10.1186/s12912-025-03301-8

BMC Nurs. 2025 Jun 20;24(1):663. doi: 10.1186/s12912-025-03307-2.

ABSTRACT

BACKGROUND: Parenting practices are relevant in shaping children’s psychological development, and positive parenting tends to be associated with positive outcomes. These practices significantly affect adolescents’ mental health by influencing depression, suicidal behaviours, and attitudes towards suicide.

AIM: To examine the predictive role of parenting styles and depression in vulnerability to suicidal ideation among university students.

METHODS: A descriptive correlational study was conducted with 480 university students recruited using stratified multistage cluster sampling from the Faculty of Health Sciences (Medicine and Nursing), Mathematical Sciences (Engineering and Computer Science), and Human Sciences (Arts and Commerce) at Port-Said University. The instruments used for data collection included the Parenting Styles and Dimensions Questionnaire (PSDQ), Beck Depression Inventory, Morey Suicidal Ideation Scale (SUI), and a sociodemographic data sheet. Statistical analysis included Spearman correlation, non-parametric tests, and mediation analysis to explore the direct and indirect relationships.

RESULTS: Participants’ ratings ranged from moderate levels of depression (13.85 ± 7.68) to suicidal ideation (10.20 ± 5.32). In this regard, participants provided higher ratings for the scores of authoritative parenting reported by both mothers and fathers, with mean scores of 48.61 ± 10.59 and 45.96 ± 10.34, respectively. Suicidal ideation was somewhat negatively related to parenting style (p < 0.001), and there was a negative relationship between depression and the maternal parenting style (p < 0.0001). In contrast, depression was positively correlated with suicidal ideation (p < 0.01).

CONCLUSION: The study concluded that Parenting styles significantly influence university students’ mental health. Warmth combined with structure in parenting, which is authoritative parenting, is associated with lower levels of depression and suicidal ideation. These findings suggest that promoting positive parenting practices may foster students’ mental well-being.

CLINICAL TRIAL: No clinical trial.

PMID:40542345 | DOI:10.1186/s12912-025-03307-2

BMC Nurs. 2025 Jun 20;24(1):661. doi: 10.1186/s12912-025-03306-3.

ABSTRACT

BACKGROUND: As artificial intelligence (AI) becomes an integral part of healthcare, nursing practice is rapidly evolving, requiring a deeper understanding of how nurses’ attitudes toward AI influence essential competencies such as creative self-efficacy and clinical reasoning competency, both of which are crucial for delivering safe and effective patient care.

AIM: This study aimed to explore the relationship between nurses’ AI-related attitudes, creative self-efficacy, and clinical reasoning competency.

METHODS: A cross-sectional descriptive-correlational design was employed, involving a convenience sample of 380 nurses working in critical care units at a university-affiliated hospital in Egypt. Data were collected using three validated instruments: the Nurses’ Artificial Intelligence Attitudes Scale, the Creative Self-Efficacy Scale, and the Clinical Reasoning Competency Scale. Data analysis included both descriptive and inferential statistics.

RESULTS: The majority of nurses demonstrated high levels of AI-related attitudes and clinical reasoning competency, while moderate levels of creative self-efficacy were observed. A strong positive correlation was found between AI attitudes and both creative self-efficacy and clinical reasoning competency (r = 0.559 and r = 0.728, p < 0.001, respectively). Regression analysis confirmed that AI attitudes were significant predictors of both creative self-efficacy and clinical reasoning competency, explaining 37.4% and 56.5% of their variance, respectively. Additionally, educational qualifications and years of nursing experience were identified as significant factors influencing these competencies.

CONCLUSION AND IMPLICATIONS: Positive attitudes toward artificial intelligence (AI) play a crucial role in enhancing nurses’ creative self-efficacy and clinical reasoning competency. Therefore, fostering positive perceptions of AI and providing targeted training are vital to prepare nurses for AI-integrated clinical environments. Integrating AI-focused content into nursing education and promoting continuous professional development are key strategies to strengthen nurses’ readiness to engage with AI-driven healthcare. Additionally, healthcare organizations and nursing leaders should create supportive environments that encourage AI adoption while preserving the principles of patient-centered care.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40542340 | DOI:10.1186/s12912-025-03306-3

BMC Infect Dis. 2025 Jun 20;25(1):806. doi: 10.1186/s12879-025-11220-x.

ABSTRACT

BACKGROUND: There is a gap between tuberculosis (TB) infection and the onset of clinical TB disease, which makes identifying TB transmission dynamics a prominent challenge. Different reports were made on the concordance of drug-resistance profiles between the household contact and the purported index case. This study investigated the drug-resistance pattern concordance of the index-household contact pair in central Ethiopia.

METHOD: A laboratory-based cross-sectional study was conducted on Mycobacterium tuberculosis isolates identified from bacteriologically confirmed pulmonary TB patients and their household contacts (HHCs) in central Ethiopia from January to December 2023. Sputum specimens were collected from index cases and presumptive HHCs and examined using the Xpert Ultra assay, Xpert XDR assay, and Mycobacterium tuberculosis culture. Descriptive statistics were used to summarize the data.

RESULT: Among 902 TB symptoms screened HHCs of 303 index cases, 20.17% (182/902) had Presumptive TB, and 7.14% (13/182) developed active tuberculosis. In index cases, 23.52% (64 /272) showed resistance to at least one of the five first-line anti-TB drugs. The prevalence of mono-resistant to STR, INH, RIF, and PZA was: 2.20% (6 /272), 2.20% (6/272), 6.25% (17/272), and 1.47% (4/272), respectively. Any first-line anti-TB drug resistance was higher among relapse cases than new cases, at 41.67% (10/24) and 21.77% (54/248), respectively. Among the RR/MDR-TB cases tested with the Xpert MTB/XDR assay, 56.81% (25/44) cases showed resistance to INH. Among these 25 INH resistance samples, 5 had no melting point on the wild ahpc gene as well as on the ahpc gene mutant. In HHCs with positive cultures, 23.07% (3/13) displayed resistance to any first-line anti-TB medication. Only 69.23% (9/13) of HHCs had isolates that aligned with the pDST pattern of the index case for all five first-line anti-TB drugs.

CONCLUSION: Nearly one-third of the household contacts have discordant drug-resistance profiles from the index patients. This study offers compelling proof that it is not advisable to treat close contacts without DST results based on the DST results of the supposed source case. The low drug resistance rate to new oral second-line drugs in this study did not guarantee the absence of resistance to each drug.

PMID:40542339 | DOI:10.1186/s12879-025-11220-x

BMC Nurs. 2025 Jun 20;24(1):665. doi: 10.1186/s12912-025-03333-0.

ABSTRACT

BACKGROUND: Nurses to assist patients make the best choices in challenging circumstances, counseling is crucial. Patients’ health and quality of life can be enhanced by healthcare providers, particularly nurses, through counseling and educational initiatives. Fibromyalgia is characterized by widespread pain that negatively impacts an individual’s ability to work. People may be able to improve their physical and mental health and accept suffering with the use of nursing counseling methods.

AIM: This study aimed to investigate the effect of counselling intervention on symptoms, pain acceptance, and the psychological well-being of patients with fibromyalgia.

DESIGN: A quasi-experimental (study and control group pre/post-test) design included 120 patients with fibromyalgia during their follow-up visits to the outpatient rheumatology clinic at El-Demerdash Hospital affiliated with Ain Shams University Hospitals, Cairo, Egypt. TOOLS FOR DATA COLLECTION: (1) Structured Interview Questionnaire for Patients with Fibromyalgia, (2) Pain Acceptance Questionnaire, (3) Psychological well-being Questionnaire.

RESULTS: Post intervention, there were statistically significant differences between the groups in terms of psychological well-being, pain acceptance, and symptoms (p < 0.05). Regarding the total level of pain acceptance post implementation of the counseling intervention, there was a highly statistically significant difference between the study and control groups. Post the implementation of the counseling intervention, there was a statistically significant difference in the study group’s anxiety, depression, vitality, positive well-being, and general health (0.03*, 0.01**). Additionally, the study group’s pain willingness and activity engagement subscales showed statistically significant differences, with a p-value of less than 0.001. Additionally, there were statistically significant differences between the groups pre and post the program’s implementation in terms of psychological well-being, pain acceptance, and symptoms (p < 0.05).

CONCLUSIONS: Patients with fibromyalgia under research report statistically significant improvements in their psychological well-being, pain acceptance, and symptoms when counseling interventions are used.

RECOMMENDATIONS: In addition to the standard nursing care provided to patients in all fibromyalgia treatment clinics, counseling interventions must be included. Clinics must schedule counseling sessions on a monthly basis. To increase their understanding and boost their mental and physical health, it should be updated on a regular basis. More study is needed to evaluate the biopsychosocial needs of such people and treat all the fibromyalgia-related signs and symptoms.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40542337 | DOI:10.1186/s12912-025-03333-0

Thromb J. 2025 Jun 20;23(1):68. doi: 10.1186/s12959-025-00760-6.

ABSTRACT

INTRODUCTION: Deep Vein Thrombosis is a significant public health concern associated with high morbidity and mortality, mainly when left undiagnosed or untreated. In Ethiopia, fragmented data from various studies have reported varying prevalence and risk factors, necessitating a comprehensive synthesis. This systematic review aimed to identify and summarize the key factors contributing to deep vein thrombosis among patients in Ethiopia.

METHODS: The study used a systematic review and meta-analysis design, sourcing evidence from various electronic databases until April 04, 2025. Data was extracted from March 10-15 and analyzed from March 15-25, with the report generation until April 04, 2025. The mortality rate was assessed using the pooled odds ratio and the pooled proportion. A meta-analysis was conducted using R software, with forest plots for visual representation. Heterogeneity was evaluated using the I² statistic. The quality of the studies was assessed using validated tools.

RESULTS: The review showed the pooled prevalence of deep vein thrombosis from eight articles was 5.6%( CI: 2.9, 8.5), with a 5% mortality rate (CI: 3, 8), and a 7.15%( CI: 2, 12) recurrence rate. Advanced age, being male, pregnancy, hypertension, diabetes, comorbid conditions, and a history of Deep Vein Thrombosis, high cholesterol level, orthopedic trauma, Alcohol consumption, and obesity, Patients with bilateral Deep Vein Thrombosis prolonged hospitalization, ward admission, and patient transfer from other hospitals, and use of central venous catheters were associate with increased the risk of Deep Vein Thrombosis development.

CONCLUSION AND RECOMMENDATION: The review showed that Deep Vein Thrombosis is a significant health concern in Ethiopia, with a prevalence of 5.6%, a mortality rate of 5%, and a recurrence rate of 7.15%. Factors such as advanced age, pregnancy, prior deep-vein thrombosis, comorbidities, intensive care unit admission, surgery, prolonged hospitalization, and central venous catheter use increase risk. To reduce DVT-related complications, routine risk assessments, early intervention strategies, and strengthened hospital protocols are essential.

REGISTRATION NUMBER: CRD420251024491 was registered with PROSPERO on 06 April 2025.

PMID:40542335 | DOI:10.1186/s12959-025-00760-6

Discov Oncol. 2025 Jun 21;16(1):1171. doi: 10.1007/s12672-025-02913-5.

ABSTRACT

BACKGROUND: Chinese patent drugs, standardized formulations rooted in traditional Chinese medicine, have gained attention for their potential to induce programmed cell death (PCD) in cancer cells. Emerging evidence suggests that these formulations may affect multiple PCD pathways, including apoptosis, autophagy, ferroptosis, pyroptosis, and necroptosis, thus offering a multifaceted approach to tumor suppression.

OBJECTIVES: This study aimed to map the global research landscape on Chinese patent drugs in cancer-related PCD, examining publication trends, principal contributors, and thematic evolutions. The analysis also sought to provide insights that could guide future investigations and clinical applications.

METHODS: Bibliometric data were extracted from the Web of Science Core Collection (1998-2023), focusing on articles investigating Chinese patent drugs and PCD in oncological contexts. R-bibliometrix was used for descriptive statistics and trend analyses, while VOSviewer generated network visualizations of co-occurring keywords, collaboration patterns, and co-citation clusters.

RESULTS: Overall publication output increased markedly, with China leading in both volume and impact. Collaboration networks revealed extensive international partnerships, underscoring global interest in standardized herbal formulations. Keyword mapping highlighted a shift from early apoptosis-centric studies to more diverse regulated cell-death pathways, indicating greater mechanistic depth and exploration of synergistic effects with conventional therapies.

CONCLUSION: Chinese patent drugs are increasingly recognized as promising agents for modulating PCD in cancer cells. Ongoing work focuses on standardized manufacturing, robust clinical validation, and mechanistic elucidation. These trends position Chinese patent drugs at a pivotal juncture for advancing integrative oncology and enhancing patient outcomes.

PMID:40542322 | DOI:10.1007/s12672-025-02913-5