Nevin Manimala

BMC Med Educ. 2025 May 5;25(1):652. doi: 10.1186/s12909-025-07224-5.

ABSTRACT

INTRODUCTION: Pharmaceutical care (PC) is a pharmacist’s responsibility, and its provision of medication-related care is meant to improve patients’ quality of life. The future of PC is in the hands of graduating pharmacy students (GPS). Good knowledge and a positive attitude toward providing PC is essential among pharmacy students. In addition, identifying and resolving perceived barriers is crucial for PC.

METHOD: A Cross-sectional study was conducted among GPS using a single-stage cluster sampling technique in North West, Ethiopia. A self-administered questionnaire was used to measure knowledge, attitude, and perceived barriers of GPS toward PC provision. The data that passed the quality check were entered and analyzed using Statically Package for Social Science version 27.0. Kruskal-Wallis H test and Mann-Whitney U test were performed to assess the difference in PC knowledge and attitude, and P-value < 0.05 was used to declare statistically significant difference.

RESULT: Overall, 140 GPS participated, giving a response rate of 90.3%, and the mean (± SD) age was 23.72 ± 2.87 years. Overall, 122 (87.1%) and 54 (38.6%) GPS have good PC knowledge and positive attitudes toward provision of PC, respectively. Half of the GPS perceived that lack of therapeutics knowledge prevents them from providing PC. Statistically significant differences were observed in PC knowledge and attitude based on institution, education level before joining the program, source of motivation, previous incomplete grades, and participation in extracurricular activities.

CONCLUSION: Graduating pharmacy students’ knowledge on PC is adequate. But only less than half of the GPS have a positive attitude toward the provision of PC. Identifying barriers and tackling them is crucial to improve practitioners’ attitude and the PC provision service. Promoting inclusive health policies on PC can improve the PC provision.

PMID:40325444 | DOI:10.1186/s12909-025-07224-5

Microb Cell Fact. 2025 May 5;24(1):98. doi: 10.1186/s12934-025-02706-z.

ABSTRACT

BACKGROUND: Alkaline proteases are useful enzymes for various industrial applications as bio-additives in detergents and in the recovery of silver from used X-ray films. Therefore, many strategies were used to increase enzyme production and reduce production costs by using microbial cultures, using agro-industrial waste, and improving growth conditions via statistical methods. The enzyme kinetics and thermodynamics were studied as well as its ability to recover silver was also evaluated.

RESULTS: An alkaline protease suitable for industrial applications was produced by Bacillus licheniformis strain-MA1. The ability of B. licheniformis strain-MA1 to produce protease was optimized using multi-factorial designs (Plackett-Burman and Box-Behnken). Optimization process improved enzyme production by 9.6-fold over that obtained from the original medium. Highest alkaline protease production was reached after 72 h at pH 7.0, 35 °C, and 150 rpm. The protease was maximally active at 50 °C and pH 9.0 with high thermal and pH stability. The protease showed high catalytic efficiency and high affinity toward substrate with low activation energy (Ea). In addition, the thermodynamic parameters of protease enzyme (enthalpy, free energy, and entropy) were also investigated and showed its superior thermal stability. At 70 °C the thermal deactivation constant (kd) was 4.75-fold higher than that at 50 °C. The higher t_0.5, D-values, and activation energy for thermal denaturation (Ed) of the protease indicated its higher thermal stability and thus its potential application in industrial processes. The compatibility of the protease with laundry detergents at 40 °C was higher than at 50 °C. In the presence of EDTA, the protease enzyme retained 93.6% of its activity. Furthermore, the crude enzyme successfully hydrolyzed the gelatin layer from X-ray films waste after 1 h enabling recycling and reuse.

CONCLUSIONS: Stable alkaline protease from B. licheniformis strain-MA1 was suitable for some industrial aspects as a bio-additive in detergents and capable of recovering silver from used X-ray.

PMID:40325442 | DOI:10.1186/s12934-025-02706-z

BMC Complement Med Ther. 2025 May 5;25(1):163. doi: 10.1186/s12906-025-04899-7.

ABSTRACT

BACKGROUND: Cerebral ischemia-reperfusion injury (CIRI) is a complex pathological process, which can further aggravate the damage of ischemic tissues. Traditional Chinese medicine (TCM) monomers, bioactive compounds extracted from Chinese herbal medicines, have been demonstrated to have various protective effects against reperfusion injury. This network meta-analysis (NMA) aimed to investigate the optimal treatment strategy of TCM monomers for CIRI in animal models.

METHODS: Four databases including PubMed, Embase, Web of Science, and Cochrane were searched up to January 06, 2024. First, prospective registration was done at PROSPERO (ID: CRD42024496289), the quality of the included studies was evaluated with SYRCLE’s risk of bias tool, and statistical analysis was conducted with Stata Version 18.0 and RStudio.

RESULTS: In total, 26 studies were included, involving 506 animals and 12 TCM monomers. The results of a meta-analysis demonstrated that, compared to the control group, puerarin, paeoniflorin, hydroxysafflor yellow A, sinomenine, and salvianolic acid significantly reduced mNSS scores. Furthermore, ginsenoside, scutellarin, and baicalein significantly reduced Longa scores. In addition, salvianolic acid treatment significantly decreased brain water content. Regarding infarct volume, bilobalide, baicalein and puerarin all demonstrated remarkable effects. The network meta-analysis suggested that paeoniflorin might be the most effective intervention in terms of mNSS score, with a surface under the cumulative ranking curve (SUCRA) value of 92.8%; Scutellarin might be the most effective intervention to reduce Longa score (SUCRA = 87.6%); And salvianolic acid might be the most effective intervention to reduce brain water content (SUCRA = 98.2%); For infarct volume specifically, bilobalide may be the most effective intervention (SUCRA = 95.5%). In our meta-regression, we found that dose and duration of treatment may contribute to heterogeneity among mNSS studies.

CONCLUSION: TCM monomers could provide a favorable neuroprotection on CIRI, with heterogeneous protective effects. Given the small number and the differences in quality of included studies, more high-quality, programmatic animal studies were needed to validate our findings.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40325432 | DOI:10.1186/s12906-025-04899-7

BMC Med Educ. 2025 May 5;25(1):654. doi: 10.1186/s12909-025-07258-9.

ABSTRACT

BACKGROUND: Medical students are the future doctors and play an essential role in the management of health issues. Their understanding of Alzheimer’s disease (AD) is not only required but also necessary to provide the best possible care to patients. The present study aimed to assess medical students’ knowledge about AD within the context of the recent reform of the Egyptian medical educational system, which switched to competency-based instead of outcome-based education since 2017.

METHODS: A descriptive cross-sectional study was conducted among medical students in public and private Egyptian medical schools. Between August and November 2024, an anonymous self-administered questionnaire was uploaded to Google Forms and distributed online through commonly used social media platforms. The Alzheimer’s Disease Knowledge Scale (ADKS), a validated and reliable tool, was used for the measurement of AD-related knowledge. Univariate and multivariable logistic regression models were used to determine the factors associated with having good or poor knowledge about AD among participants.

RESULTS: In total, 1100 medical students were included through convenience and snowball sampling methods; their mean age was 20.9 ± 1.9 years, 55.5% were males, 59.6% were in their clinical years, and 15.6% had a positive family history of AD. The students’ mean knowledge score was 19.10 ± 2.96 out of 30, representing 63.7% of answers correct, with a range of scores between 9 and 29. About 70.8% of the sample had good knowledge. The highest percentage of correct answers was for the treatment and management domain (76.5%), while the lowest percentage was for the caregiving domain (52.2%). Predictors of good knowledge were females [adjusted odds ratio (aOR) = 1.33 (95% confidence interval (CI): 1.01-1.76, p = 0.043], attending a public university [aOR = 1.62 (95% CI: 1.09-2.41), p = 0.015), clinical year students [aOR = 1.53 (95% CI: 1.07-2.16), p = 0.018], living in an urban area [(aOR = 1.67 (95% CI: 1.23-2.25), p < 0.001], and having higher family monthly income [aOR = 1.75 (95% CI: 1.13-2.72), p = 0.012].

CONCLUSIONS: The study highlights gaps in Egyptian medical students’ knowledge of AD. Knowledge gaps were found in domains of caregiving and risk factors, urging educators and policymakers to enhance curricula, particularly preclinical curricula, with a specific focus on some socio-economic determinants.

PMID:40325427 | DOI:10.1186/s12909-025-07258-9

BMC Oral Health. 2025 May 5;25(1):685. doi: 10.1186/s12903-025-06011-4.

ABSTRACT

BACKGROUND: The repeated firings can enhance shade matching, translucency, and strength; however, they may also lead to color shifts. Previous research suggests that multiple firings enhance these properties to a certain extent; however, the impact of staining techniques remains underexplored. The aim of this study is to investigate the effect of staining techniques and multiple firings on the translucency, color and biaxial flexural strength of advanced lithium disilicate ALD containing Virgilite crystals.

METHODS: Sixty-three discs of ALD (CEREC Tessera^®) were divided into 3 groups based on staining techniques (n = 21); group CO (glaze only), group SC (single-step characterization), and group DC (double-step characterization). The discs were then subjected to either 2, 4, or 6 firing cycles, resulting in 9 groups (n = 7): COII, COIV, COVI, SCII, SCVI, DCII, DCIV, and DCVI. Relative translucency parameter (RTP), color change (ΔE), and biaxial flexural strength were measured, then discs were analyzed using SEM. Data were statistically analyzed using ANOVA, Bonferroni correction, and Spearman’s correlation (α = 0.05).

RESULTS: Repeated firing and staining techniques significantly affected translucency, color change, and biaxial flexural strength (p < 0.001). Translucency increased with firings, highest in CO and lowest in DC. ΔE increased with firings, highest for DC and lowest in CO. The biaxial flexural strength of the CO group remained stable across firing cycles, with no significant changes. The SC group, initially the weakest, showed a significant increase, reaching its peak after six cycles. The DC group had high strength in the fourth cycle, with a significant difference observed between the second and fourth cycles. By the sixth cycle, all groups showed comparable strength with no significant differences.

CONCLUSIONS: Within the limitation of this study, firing cycles and staining techniques impact the properties of ALD. More firing cycles enhance translucency but increase color change. Repeated firing, particularly with the double-step characterization technique, significantly improved biaxial flexural strength up to the fourth cycle, demonstrating its superior performance over the single-step characterization technique.

PMID:40325418 | DOI:10.1186/s12903-025-06011-4

BMC Psychol. 2025 May 5;13(1):467. doi: 10.1186/s40359-025-02723-y.

ABSTRACT

BACKGROUND: Pregnancy involves a combination of physical, social, and emotional changes that can lead to mental health issues, potentially impacting fetal health, childbirth success, and breastfeeding. The present study was conducted to compare anxiety, self-compassion, perceived social support and resilience in two groups of primiparous pregnant women who were either not attending or, fully attending childbirth preparation classes.

METHODS: This descriptive-analytic cross-sectional study included 210 pregnant women who attended comprehensive health centers in Khoy from 2023 to 2024. Participants were selected through random sampling. Data were collected using a demographic characteristics form, the Self-Compassion Scale – Short Form (SCS-SF), the Connor-Davidson Resilience Scale (CD-RISC), the Pregnancy-Related Anxiety Questionnaire – Revised 2 (PRAQ-R2), and the Multidimensional Scale of Perceived Social Support (MSPSS). The specific statistical tests (chi-square, independent t-test, Mann-Whitney U) were used in SPSS 16 software, at a significance level of p < 0.05.

RESULTS: The mean score of anxiety was lower in the group of pregnant women fully attending the classes compared to the non-attending group of women (p < 0.001). Additionally, mean scores of self-compassion(p < 0.001), resilience(p < 0.001), and perceived social support (p < 0.001) were significantly higher among women fully attending these classes (p < 0.001).

CONCLUSION: Given the lower anxiety and higher self-compassion, resilience, and perceived social support observed in women fully attending childbirth preparation classes, healthcare providers should consider implementing supportive interventions to enhance maternal mental health.

PMID:40325412 | DOI:10.1186/s40359-025-02723-y

Environ Microbiome. 2025 May 5;20(1):47. doi: 10.1186/s40793-025-00704-7.

ABSTRACT

INTRODUCTION: Metagenomics, the genomic analysis of all species present within a mixed population, is an important tool used for the exploration of microbiomes in clinical and environmental microbiology. Whilst the development of next-generation sequencing, and more recently third generation long-read approaches such as nanopore sequencing, have greatly advanced the study of metagenomics, recovery of unbiased material from microbial populations remains challenging. One promising advancement in genomic sequencing from Oxford Nanopore Technologies (ONT) is adaptive sampling, which enables real-time enrichment or depletion of target sequences. As sequencing technologies continue to develop, and advances such as adaptive sampling become common techniques within the microbiological toolkit, it is essential to evaluate the benefits of such advancements to metagenomic studies, and the impact of methodological choices on research outcomes.

AIM AND METHODS: Given the rapid development of sequencing tools and chemistry, this study aimed to demonstrate the impacts of choice of DNA extraction kit and sequencing chemistry on downstream metagenomic analyses. We first explored the quality and accuracy of 16S rRNA amplicon sequencing for DNA extracted from the ZymoBIOMICS Microbial Community Standard, using a range of commercially available DNA extraction kits to understand the effects of different kit biases on assessment of microbiome composition. We next compared the quality and accuracy of metagenomic analyses for two nanopore-based ligation chemistry kits with differing levels of base-calling error; the older and more error-prone (~ 97% accuracy) LSK109 chemistry, and newer more accurate (~ 99% accuracy) LSK112 Q20 + chemistry. Finally, we assessed the impact of the nanopore sequencing chemistry version on the output of the novel adaptive sampling approach for real-time enrichment of the genome for the yeast Saccharomyces cerevisiae from the microbial community.

RESULTS: Firstly, DNA extraction kit methodology impacted the composition of the yield, with mechanical bead-beating methodologies providing the least biased picture due to efficient lysis of Gram-positive microbes present in the community standard, with differences in bead-beating methodologies also producing variation in composition. Secondly, whilst use of the Q20 + nanopore sequencing kit chemistry improved the base-calling data quality, the resulting metagenomic assemblies were not significantly improved based on common metrics and assembly statistics. Most importantly, we demonstrated the effective application of adaptive sampling for enriching a low-abundance genome within a metagenomic sample. This resulted in a 5-7-fold increase in target enrichment compared to non-adaptive sequencing, despite a reduction in overall sequencing throughput due to strand-rejection processes. Interestingly, no significant differences in adaptive sampling enrichment efficiency were observed between the older and newer ONT sequencing chemistries, suggesting that adaptive sampling performs consistently across different library preparation kits.

CONCLUSION: Our findings underscore the importance of selecting a DNA extraction methodology that minimises bias to ensure an accurate representation of microbial diversity in metagenomic studies. Additionally, despite the improved base-calling accuracy provided by newer Q20 + sequencing chemistry, we demonstrate that even older ONT sequencing chemistries can achieve reliable metagenomic sequencing results, enabling researchers to confidently use these approaches depending on their specific experimental needs. Critically, we highlight the significant potential of ONT’s adaptive sampling technology for targeted enrichment of specific genomes within metagenomic samples. This approach offers broad applicability for enriching target organisms or genetic elements (e.g., pathogens or plasmids) or depleting unwanted DNA (e.g., host DNA) in diverse sample types from environmental and clinical studies. However, researchers should carefully weigh the benefits of adaptive sampling against the potential trade-offs in sequencing throughput, particularly for low-abundance targets, where strand rejection can lead to pore blocking. These results provide valuable guidance for optimising adaptive sampling in metagenomic workflows to achieve specific research objectives.

PMID:40325409 | DOI:10.1186/s40793-025-00704-7

BMC Public Health. 2025 May 5;25(1):1654. doi: 10.1186/s12889-025-22923-w.

ABSTRACT

BACKGROUND: People with disabilities (PWD) may be more vulnerable to the adverse health effects of air pollution than the general population. This study examined the association between long-term exposure to ambient fine particulate matter (PM_2.5) and mortality risk in PWD considering disability type and severity.

METHODS: Data from the Korean National Health Insurance Service and Statistics Korea were analyzed in this retrospective cohort study, including 2,880,265 individuals (41,501,709 person-years), of which 176,410 were PWD (2,011,231 person-years). PM_2.5 exposure was estimated using simulated data from 2006 to 2019. Causes of death included all causes, non-accidental causes, respiratory disease, lung cancer, and cardiovascular disease. Cox proportional hazard models were used to estimate hazard ratios (HRs) for mortality associated with PM_2.5 stratified by disability type and severity.

RESULTS: PWD, particularly those with severe disabilities or specific impairments such as kidney problems or brain lesions, showed significantly high mortality risks from all causes, non-accidental causes, and cardiovascular diseases due to PM_2.5 exposure. For individuals with kidney impairment, the HR (95% confidence interval) for mortality on increasing PM_2.5 by 10 µg/m³ was 1.79 (1.27-2.52) from all causes, while for those with brain lesions, it was 1.10 (1.00-1.22) from cardiovascular disease. PWD were not susceptible to mortality from respiratory causes.

CONCLUSIONS: This study highlights the increased vulnerability of PWD, especially those with severe disabilities or specific impairments, to the adverse effects of PM_2.5 exposure. Targeted interventions tailored to disability type and severity, along with stricter air quality standards and specialized healthcare approaches, are needed.

PMID:40325394 | DOI:10.1186/s12889-025-22923-w

BMC Med Educ. 2025 May 5;25(1):648. doi: 10.1186/s12909-025-07029-6.

ABSTRACT

The aim of this study was to introduce and validate an Objective Structured Clinical Examination (OSCE) as a robust assessment tool for evaluating clinical skills in audiology among third-year audiology and speech-language students. Drawing on guidelines for OSCE development, key competencies and clinical skills in audiology were identified through expert consultation. Four OSCE stations were designed comprising one theoretical and three practical stations covering essential clinical tasks. Content validity was measured using the Content Validity Coefficient (CVC), while inter-rater reliability was assessed using the Kappa coefficient and Intraclass Correlation Coefficient (ICC). The study involved 33 audiology students and eight audiologist expert evaluators. The study demonstrated high content validity of the OSCE, with CVC scores ranging from 0.97 to 1 across all stations. Inter-rater reliability analysis revealed substantial to almost perfect agreement among evaluators, with ICC values ranging from 0.94 to 0.99. Comparison of scores between evaluators revealed minimal statistically significant differences, indicating overall consistency in assessment. The results provide substantial evidence supporting the content validity, inter-rater agreement, and reliability of the Objective Structured Clinical Examination (OSCE) as an effective tool for assessing the clinical skills of audiology and speech-language pathology students in the area of audiology.

PMID:40325386 | DOI:10.1186/s12909-025-07029-6

Int J Equity Health. 2025 May 5;24(1):120. doi: 10.1186/s12939-025-02492-5.

ABSTRACT

BACKGROUND: HIV care continuum engagement is inadequate among African American/Black and Latine (AABL) young/emerging adults living with HIV in the United States. Within this population, some subgroups face barriers to research and are under-studied. Grounded in social action theory, the present study focuses on a diverse community-recruited cohort including those with non-suppressed HIV viral load. Using a sequential explanatory mixed methods design, we describe contextual self-regulatory resources (e.g., substance use, mental health), and their relationships to HIV management.

METHODS: Participants (N = 271) engaged in structured baseline assessments and biomarker testing (HIV viral load, drug screening). Being well-engaged in HIV care and HIV viral suppression were the primary outcomes. We purposively sampled a subset for maximum variability for in-depth interviews (N = 41). Quantitative data were analyzed via descriptive statistics and logistic regression, and results were used to develop qualitative research questions. Then, qualitative data were analyzed via directed content analysis. The joint display method was used to integrate results.

RESULTS: Participants’ mean age was 25 years (SD = 2). The majority (59%) were Latine/Hispanic and 41% were African American/Black. Nearly all were assigned male sex at birth (96%) and identified as gay/bisexual/queer (93%). The average HIV diagnosis was 4 years prior (SD = 3). The majority were well-engaged in HIV care (72%) and evidenced viral suppression (81%). Substance use (tobacco, marijuana, alcohol) was prevalent, mainly at low- and moderate-risk levels. Drug screening indicated marijuana, methamphetamine, and MDMA were the most common recent substances. Symptoms of depression and PTSD were associated with decreased odds of engagement in care. High-risk cannabis use was associated with decreased odds of HIV viral suppression. Qualitative results highlighted the prevalence of substance use in social networks and venues, and the importance of substances as a coping strategy, including for mental health distress. Tobacco and methamphetamine (but not marijuana) were described as problematic, and marijuana was used as harm reduction. Substance use was more common among those with non-suppressed versus suppressed HIV viral load. However, overall, substance use did not commonly interfere substantially with HIV management.

CONCLUSIONS: The present study advances knowledge on AABL young/emerging adults living with HIV and highlights ways to improve screening and services.

PMID:40325383 | DOI:10.1186/s12939-025-02492-5