Nevin Manimala

BMC Nurs. 2025 Feb 27;24(1):222. doi: 10.1186/s12912-025-02870-y.

ABSTRACT

BACKGROUND: Occupational violence is a significant issue for nurses worldwide, impacting their well-being, job satisfaction, and patient care quality. This study investigated the prevalence, types, and effects of such violence on nursing staff in surgical wards in Murzuq locality hospitals, Libya, to inform effective prevention strategies.

METHODS: This cross-sectional study examined occupational violence against nursing staff in surgical wards across three hospitals in Murzuq, Libya. Using a convenience sampling approach, data were collected from 50 nurses in general surgical and emergency surgical wards over four weeks through a self-administered questionnaire. The variables included demographic data (gender, experience) and information on violence types, sources, impacts, and reduction strategies. The data were analysed via SPSS v27, with descriptive statistics applied. For inferential statistics, the chi-square test and Fisher’s exact test were conducted at a significance level of 0.05. Ethical approval was obtained from the academic research committee of Fezzan University, and informed consent was secured from all participants.

RESULTS: Verbal insults (60%) and discrimination (64%) were the most reported types of violence. Patient companions (68%) were identified as the primary source, followed by patients (40%) and colleagues (28%). Occupational violence significantly impacted nurses’ lives, with 62% reporting stress, 48% experiencing decreased job satisfaction, and 28% considering leaving their jobs. Additionally, 40% reported difficulty concentrating due to violence. Significant associations were found between gender and sources of violence (p ≤ 0.001) and between years of experience and types, sources, and impacts of violence (p ≤ 0.001).

CONCLUSION: These findings underscore the need for gender-sensitive interventions, comprehensive training, and support mechanisms to address workplace violence. Future research should explore the long-term effects of violence on nursing staff and the effectiveness of tailored interventions in different healthcare settings. The results highlight the critical role of improving work conditions and organizational policies to enhance workplace safety for nurses.

PMID:40016728 | DOI:10.1186/s12912-025-02870-y

BMC Womens Health. 2025 Feb 27;25(1):89. doi: 10.1186/s12905-025-03608-3.

ABSTRACT

PURPOSE: The aim of this study was to investigate the expression and clinical implications of CCN family member 5 (CCN5) and the oestrogen receptor (ER) in advanced breast cancer (BC).

METHODS: A total of 130 patients with advanced BC were selected for the study. Samples of normal breast tissue, ductal carcinoma in situ (DCIS), and invasive carcinoma were collected. The expression levels of CCN5 and ER in these tissues were examined using immunohistochemical methods. The correlation between expression of CCN5 and ER in different tissues and also differences in expression in invasive carcinoma were analysed. In addition, the relationship between CCN5 expression in advanced BC tissues and clinical pathological features was examined.

RESULTS: CCN5 and ER had low expression in normal breast tissues and invasive carcinoma tissues, but high expression in DCIS, with this difference being statistically significant (X² = 119.899, P < 0.001; X² = 113.524, P < 0.001, respectively). The expression of CCN5 and ER in different tissues of patients with advanced BC showed a positive correlation. Significant differences were also observed in the positive and negative expression of CCN5 and ER (X² = 56.358, P < 0.001). Moreover, the expression of CCN5 protein in advanced BC showed a statistically significant associations (P < 0.05) with the expression of the progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), Ki-67, and P53, tumor diameter, histological grade, lymph node metastasis, pathological molecular subtype, and clinical staging.

CONCLUSION: High expression of CCN5 and ER was observed in DCIS tissues of patients with advanced BC, with their expression being positively correlated. These findings suggest that CCN5 and ER may have a potential synergistic role in the progression of BC that influences the progression of advanced BC and can also be used to predict the effectiveness of endocrine therapy.

PMID:40016720 | DOI:10.1186/s12905-025-03608-3

BMC Public Health. 2025 Feb 27;25(1):799. doi: 10.1186/s12889-025-22062-2.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had repercussions in several areas. The indirect effects of the pandemic on healthy living behaviours are multiple and complex to assess. The aim is to assess the impact of the outbreak of COVID-19 pandemic in Italy on the most relevant modifiable behaviours risks for non-communicable diseases (NCDs).

METHODS: PASSI 2008-2023 data referring to a sample of 18-69-year-olds residing in Italy was used to estimate the prevalences of smoking, alcohol, fruit and vegetable consumption, and physical inactivity lifestyle. For each of these risks was used an interrupted time series (ITS) study with Generalized Least Squares (GLS) model to assess trends before and after the pandemic’s outbreak in Italy (March 2020). The “intervention” period is postulated as March 2020, and the “post-intervention” period extends from April 2020 to December 2023. In these models, the hypothetical situation without “intervention” and with the trend remains unchanged is commonly known as the ‘counterfactual’ scenario. Through ITS model both “counterfactual data” and “factual data” were obtained.

RESULTS: From 2008 to 2023, 532,115 people were interviewed. Results showed, during “post-intervention” period, significant differences between factual and counterfactual prevalences started in 2022 and strengthened during 2023 and for all of the four behavioural indicators analysed: smoking, high-risk alcohol consumption, fruit and vegetable consumption (both all three of them worsening) and physical inactivity (which appears to decrease). Current smokers exhibited similar prevalences in March 2020 (24.5% vs. 24.3%), followed by a plateau throughout the entire ‘post-intervention’ period. By December 2023, however, the counterfactual prevalence was significantly lower than the observed rate (24.5% factual vs. 22.7% counterfactual). The initial improvement observed in the prevalence of high-risk drinkers in March 2020 (13% factual vs. 17% counterfactual) was followed by a rapid worsening and in December 2023 the prevalence was significantly higher than expected (19.7% vs. 16.9%). The fruit and vegetable consumption worsened and the factual prevalence of five-a-day in December 2023 was significantly lower than counterfactual (6.6% vs. 9.0%). Physical inactivity following an initial worsening in March 2020 (albeit not statistically significant), appeared to decrease in December 2023, with the factual prevalence lower than counterfactual (26.9% vs. 32.4%).

CONCLUSIONS: Results found in this article showed at the end of studied period the achievement of a plateau for current smokers, a worsening in the high-risk alcohol consumption, in fruit and vegetable intakes and a reduction in physical inactivity. Understanding shifts in these lifestyle indicators is crucial for the proper design of interventions aimed at reducing the burden of NCDs.

PMID:40016716 | DOI:10.1186/s12889-025-22062-2

BMC Public Health. 2025 Feb 27;25(1):797. doi: 10.1186/s12889-025-22083-x.

ABSTRACT

BACKGROUND: Tuberculosis (TB) is a major public health problem, and understanding the geographic distribution of the disease is critical in planning and evaluating intervention strategies. This manuscript illustrates the application of Group-Based Trajectory Modeling (GBTM), a statistical method that analyzes the evolution of an outcome over time to identify groups with similar trajectories. Specifically, we apply GBTM to identify the evolution of the number of TB notifications over time across various geographic locations, aiming to identify groups of locations with similar trajectories. Locations sharing the same trajectory may be considered geographic TB clusters, indicating areas with similar TB notifications. We used data abstracted from clinic records in Limpopo province, South Africa, treating the clinics as a proxy for the spatial location of their respective catchment areas.

METHODS: Data for this analysis were obtained as part of a cluster-randomized trial involving 56 clinics to evaluate two active TB patient-finding strategies in South Africa. We utilized GBTM to identify groups of clinics with similar trajectories of the number of TB patients.

RESULTS: We identified three trajectory groups: Groups 1, comprising 57.8% of clinics; Group 2, 33.9%; and Group 3, 8.3%. These groups accounted for 30.8%, 44.4%, and 24.8% of total TB-diagnosed patients, respectively. The estimated mean number of TB-diagnosed patients was highest in trajectory group 3 followed by trajectory group 2 across the 12 months, with no overlap in the corresponding 95% confidence intervals. The estimated mean number of TB-diagnosed patients over time was fairly constant for trajectory groups 1 and 2 with exponentiated slopes of 0.979 (95% CI: 0.950, 1.004) and 1.004 (95% CI: 0.977, 1.044), respectively. In contrast, there was a statistically significant 3.8% decrease in the number of TB patients per month for trajectory group 3 with an exponentiated slope of 0.962 (95% CI: 0.901, 0.985) per month.

CONCLUSIONS: GBTM is a powerful tool for identifying geographic clusters of varying levels of TB notification when longitudinal data on the number of TB diagnoses are available. This analysis can inform the planning and evaluation of intervention strategies.

PMID:40016712 | DOI:10.1186/s12889-025-22083-x

Burns. 2025 Feb 18;51(4):107427. doi: 10.1016/j.burns.2025.107427. Online ahead of print.

ABSTRACT

INTRODUCTION: Split-thickness skin autografts are the gold standard for surgical treatment of burns. In preclinical studies, the use of SKINHEALTEX PLGA, an electrospun poly(lactic-co-glycolide) acid (PLGA) bioveil, placed between autografts and their bed has shown potential to stimulate dermal regeneration, increase graft take and improve scar quality. These properties have not yet been evaluated in human clinical trials.

OBJECTIVE: The primary goal of this study was to evaluate tolerability and safety of SKINHEALTEX PLGA on human tissues, specifically, split-thickness skin autografts and wound beds of debrided burns.

MATERIALS AND METHODS: A double-blind randomised controlled clinical trial was conducted with adult patients with deep burns requiring surgical treatment, for 4 years (November 2018 to September 2022). Each patient acted as their own control, and they were followed for 12 months. In the control area a skin autograft was applied, while in the treatment area SKINHEALTEX PLGA was interposed between the autograft and the bed. The outcome variables were incidence of adverse events, the percentage of graft take (evaluated clinically), and Vancouver Scar Scale and Patient and Observer Scar Assesment Scale scores.

RESULTS: The bioveil was well tolerated in the 26 patients that were recruited. No adverse events related to SKINHEALTEX PLGA were observed. No statistically significant differences were observed in split-thickness skin autograft take and subsequent scar quality between the control group (split-thickness skin autografts alone) and the autograft and SKINHEALTEX PLGA group.

CONCLUSION: This is the first clinical trial investigating the application of an electrospun biomaterial in the treatment of burns using skin autografts. SKINHEALTEX PLGA is a biocompatible and safe product that can be applied as an interface between autografts and the debrided bed of a burn without reducing graft take. Further research is needed to assess the value of SKINHEALTEX PLGA for burn wounds and its potential as an administration route of molecules than enhance dermal regeneration in burn patients.

PMID:40014884 | DOI:10.1016/j.burns.2025.107427

JMIR Form Res. 2025 Feb 11. doi: 10.2196/67637. Online ahead of print.

ABSTRACT

BACKGROUND: As alcohol misuse remains pervasive within the military, evidence-based prevention programs that are feasible to implement and appropriately tailored to meet the needs and norms of military personnel are critically needed. Further, programs that target future military leaders, such as trainees, recruits, and cadets, may be especially impactful. eCHECKUP TO GO is an online, evidence-based brief alcohol intervention designed to reduce alcohol misuse through education and personalized feedback that may be suitable for military trainees. However, because it was developed for civilian students, efforts to adapt the content for military settings are needed.

OBJECTIVE: The objective of this study was to evaluate the acceptability of a military version of eCHECKUP TO GO, tailored to include military-specific terminology and alcohol use statistics.

METHODS: US Air Force Academy cadets were recruited to participate in a single-arm, mixed methods study. Following completion of eCHECKUP TO GO, participants completed a survey that assessed satisfaction with specific aspects of the user experience, including ease of use, design, and relevance of the information and personalized feedback (range: 1 [strongly disagree] to 7 [strongly agree]). A subset of cadets also participated in a focus group to expound on the survey responses.

RESULTS: Survey participants included 22 cadets (54.5% male; mean [M] age 19.6 years, SD 1.8). Six cadets (27.2%) also participated in the focus group. Participants were satisfied with the program overall (M 5.8, SD 0.9) and gave the highest ratings to ease of use (M 6.6, SD 0.7), site design (M 6.5, SD 0.6), and site interactivity (M 6.4, SD 1.0). Items pertaining to tailoring, relevance, and amount of content specific to cadets scored lowest (M 5.8, SD 1.4; M 5.6, SD 1.4; M 5.5, SD 1.5, respectively). Most (68.2%) said they would act upon the information they were provided. Focus group participants made suggestions for improved tailoring, such as increasing content on social aspects of drinking and military-specific risks of alcohol misuse (eg, Uniform Code of Military Justice violations).

CONCLUSIONS: Although acceptability of eCHECKUP TO GO was high, continued efforts are needed to ensure the content accurately reflects the experiences of cadets. Researchers who design military health promotion interventions need to consider the varied contexts within the force and rigorously evaluate the acceptability of all content before implementation.

PMID:40014874 | DOI:10.2196/67637

Perfusion. 2025 Feb 27:2676591251324648. doi: 10.1177/02676591251324648. Online ahead of print.

ABSTRACT

BACKGROUND: A gap in knowledge exists related to optimal bivalirudin dosing in children. The purpose of our analysis is to use quantitative methods and baseline data to quickly predict the optimal therapeutic bivalirudin dose for children.

METHODS: We developed an internal database of pediatric patients on ECMO or VAD, including baseline patient information, bivalirudin doses, and partial thromboplastin time (PTT) measurements throughout the treatment period. We fit an analysis of covariance (ANCOVA) model to the baseline data to determine the best predictors of therapeutic bivalirudin dose. We used five-fold cross-validation to ensure the model was not overfitting to any specific data subset.

RESULTS: The most notable variables that were statistically significant (p < .05) were: the primary use of bivalirudin for heart failure prophylaxis, no complications before bivalirudin administration, other reasons for bivalirudin use, other race (including Asian, pacific islander, and native American), Hispanic or Latinx ethnicity, primary diagnosis of heart failure, and primary diagnosis of myocarditis. To compare our model-predicted dose and the actual starting dose administered to the patients, we looked at how far off each of those was from the therapeutic dose. The mean of absolute differences was 0.28 mg/kg/hr for the administered starting dose and 0.23 mg/kg/hr for the model-predicted dose; therefore, the model results in an improvement of 18% in the difference from the therapeutic dose.

CONCLUSION: Our model provides an initial framework for determining a starting bivalirudin dose that takes into account patient demographic information and baseline admission data.

PMID:40014868 | DOI:10.1177/02676591251324648

JCO Glob Oncol. 2025 Feb;11:e2400530. doi: 10.1200/GO-24-00530. Epub 2025 Feb 27.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the current availability and distribution of radiotherapy (RT) and nuclear medicine equipment in Vietnam, focusing on the shortage of linear accelerators (LINACs), positron emission tomography/computed tomography (PET/CT) scanners, and brachytherapy units. The study seeks to quantify these shortages and highlight the implications for cancer treatment access and outcomes.

METHODS: Data were collected from 50 hospitals across Vietnam that provide RT services or nuclear medicine imaging. The availability of LINACs, PET/CT devices, brachytherapy units, and other essential equipment was assessed, alongside patient loads and machine utilization rates. National data were compared with the standard in developed countries, with a particular focus on the International Atomic Energy Agency’s (IAEA) recommendations for RT infrastructure.

RESULTS: Vietnam has a total of 82 LINACs, resulting in a LINAC density of 0.82 per million people, which is far below the standard in developed countries of 4-8 per million. Of the existing LINACs, 43% are outdated and unable to deliver advanced RT techniques such as volumetric modulated arc therapy. Additionally, the country has only 12 PET/CT scanners and three cyclotrons, which limits access to early cancer diagnosis and treatment planning. The central region of Vietnam is particularly underserved, with only 1 PET/CT device and limited access to brachytherapy services. Long wait times for RT-often up to 2 weeks-are common, leading to delayed treatments and reduced treatment efficacy. Patients, particularly those with conditions requiring timely RT after chemotherapy, face increased risks because of these delays.

CONCLUSION: The shortage of modern RT and nuclear medicine equipment in Vietnam critically limits timely access to cancer treatment, affecting patient outcomes and placing a heavy burden on health care providers. Expanding access to advanced RT technology through government investment, public-private partnerships, and international collaborations with organizations such as the IAEA could alleviate these challenges. Increasing Vietnam’s RT capacity is essential for improving cancer care outcomes and managing the rising burden of cancer across the country.

PMID:40014841 | DOI:10.1200/GO-24-00530

JCO Glob Oncol. 2025 Feb;11:e2400312. doi: 10.1200/GO-24-00312. Epub 2025 Feb 27.

ABSTRACT

PURPOSE: Patients receiving immune checkpoint inhibitors (ICIs) may induce immune-related adverse events (irAEs). This study aimed to evaluate the toxicity induced by ICIs and explore the correlation between efficacy and toxicity in a Moroccan population.

METHODS: We conducted a prospective study of patients with solid tumors who received pembrolizumab or atezolizumab at the National Institute of Oncology, Rabat from July 2018 to December 2023. We identified irAEs according to ASCO 2021 guidelines and graded them according to the Common Terminology Criteria for Adverse Events Version 4.0. Efficacy with respect to progression-free survival (PFS) and overall survival (OS) was determined. A Cox regression model was used to determine the association between irAEs and survival.

RESULTS: Eighty-six patients with solid tumors who received ICIs were included. The primary tumor types were lung (40.7%), skin (29.1%), and GI cancer (14%). The ICIs most commonly used included pembrolizumab (67.4%) and atezolizumab (32.6%). ICIs were used as monotherapy (77.9%) or in combination (22.1%). A total of 58 (67.4%) patients presented any kind of irAEs. The most common toxicities in both the monotherapy and combination groups were GI, with rates of 25.3% and 31.5%, respectively. Patients with irAEs showed significantly longer median PFS compared with those without irAEs (9 v 3.6 months; hazard ratio [HR], 0.5 [95% CI, 0.32 to 0.99]; P = .04). The median OS was longer in patients with irAEs than in those without irAEs but was not statistically significant (19 v 10.3 months; HR, 0.8 [95% CI, 0.39 to 1.7]; P = .5).

CONCLUSION: Our results indicated that ICIs have the potential to induce irAEs in patients with solid tumors. These adverse effects were commonly GI. The development of irAEs was associated with improved effectiveness of ICI treatment across different malignancies.

PMID:40014840 | DOI:10.1200/GO-24-00312

Acta Odontol Latinoam. 2024 Dec;37(3):262-269. doi: 10.54589/aol.37/3/262.

ABSTRACT

Rehabilitating teeth after root canal treatment often requires the use of glass fiber posts (GFPs) to retain the final restorations, so the choice of resin cement is critical for bond strength (BS) and treatment success.

AIM: The aim of this study was to evaluate the effect of different GFP systems on BS to intraradicular dentin using two dual-curing resin cement types.

MATERIALS AND METHOD: Thirty bovine incisors with wide canals were filled endodontically with gutta-percha and epoxy resin sealer. Initially, the canal filling was removed, and 4 mm of the apical seal was left intact. The teeth were divided into three groups according to the GFPs used: AP (anatomical posts – prefabricated GFP (Reforpost #2, Angelus®) relined with composite resin (Filtek Z350, 3M ESPE); SPLENDOR (Splendor SAP, Angelus®), and milled CAD/CAM (FiberCAD, Angelus®). Posts were fixed with conventional (RelyX Ultimate, 3M ESPE) or self-adhesive resin cement (RC) (RelyX U200, 3M ESPE), following the manufacturer’s instructions. After 48 h, the roots were sectioned into thirds and subjected to pushout BS testing using a universal testing machine. BS data were analyzed using Wilcoxon and Mann- Whitney U tests. Failure modes were assessed with Fisher’s Exact test (α=0.05).

RESULTS: In the apical and middle root sections, BS was similar in the AP and Splendor groups, both of which performed better than the milled CAD/CAM group (p≤0.05). In the cervical section, BS was significantly higher for the anatomical posts than for Splendor and milled CAD/CAM posts. Self-adhesive RC promoted statistically lower BS compared to conventional RC for the milled CAD/CAM post in the cervical and middle thirds (p≤0.05). Self-adhesive RC provided statistically higher bond strength than conventional RC for the anatomical post in the apical third (p≤0.05). No significant difference in failure modes was observed between resin cements and different root sections (p>0.05).

CONCLUSION: The BS of the GFP system was affected by resin cement type and root section, with composite resin-relined anatomically shaped posts generally performing better.

PMID:40014824 | DOI:10.54589/aol.37/3/262