Nevin Manimala

Nurs Crit Care. 2025 Mar;30(2):e70000. doi: 10.1111/nicc.70000.

ABSTRACT

BACKGROUND: Ventilator-associated pneumonia (VAP) is a frequent and severe complication among newborns in neonatal intensive care units (NICUs). It is associated with elevated morbidity and mortality rates, more extended hospital stays and increased health care costs. Implementing preventive care bundles and structured sets of evidence-based practices reduces VAP incidence. As primary caregivers, nurses are critical in consistently applying these preventive measures in NICU settings.

AIM: To evaluate the impact of a structured training programme on nurses’ practices in the prevention of VAP among ventilated newborns in NICUs.

STUDY DESIGN: This prospective, pre- and post-intervention study was conducted with 27 nurses caring for mechanically ventilated newborns. All newborns admitted to the NICU who met inclusion criteria were included in the study (34 newborns pre-intervention, 38 newborns post-intervention and 41 newborns 3 months after the intervention).

RESULTS: The results indicate significantly improved nurses’ practices for VAP prevention across the core, equipment-related general measures, with total mean scores increasing from 50.67% (95% CI: 44.30-56.92) pre-programme to 89.26% (95% CI: 85.68-92.84) immediately post-programme and 73.33% (95% CI: 67.79-78.88) after 3 months (p < .001). Before the programme, 85.3% of newborns developed VAP. However, this dropped dramatically to just 10.5% immediately after the programme, with a relative risk of 0.123 (95% CI: 0.046-0.328, p < .001). Even 3 months later, the rates remained much lower at 19.5% than before the programme, with a relative risk of 0.228 (95% CI: 0.117-0.445, p < .001). Multivariate logistic regression showed that only overall nurses’ practices remained statistically significant in reducing VAP risk (OR = 0.819, 95% CI: 0.728-0.920, p = .001) after adjusting for confounders. Prolonged ventilation and individual components of nursing practices were not significant in the multivariate model.

CONCLUSIONS: This study demonstrates that a structured educational programme can significantly enhance nurses’ adherence to VAP preventive practices and reduce VAP incidence. Regular training initiatives are crucial for sustaining high care standards, thereby improving neonatal patient health care outcomes.

RELEVANCE TO CLINICAL PRACTICE: Newborns in the neonatal intensive care unit (NICU) are at a higher risk of developing ventilator-associated pneumonia (VAP) because of their fragile immune systems, the need for mechanical ventilation and prolonged hospital stays. VAP can lead to severe complications, including increased morbidity, mortality and long-term health issues. Training NICU nurses on VAP prevention care bundles is crucial for improving neonatal care, reducing preventable infections and optimizing clinical outcomes in a highly vulnerable neonatal population. It supports evidence-based practice, enhances nurse competence and contributes to the overall quality of care in neonatal intensive care settings. As a result, implementing such a training programme should be a top priority in NICU clinical practice.

PMID:40074557 | DOI:10.1111/nicc.70000

J Genet Eng Biotechnol. 2025 Mar;23(1):100475. doi: 10.1016/j.jgeb.2025.100475. Epub 2025 Mar 5.

ABSTRACT

Leprosy remains a significant health concern, particularly in India, Brazil, and Indonesia. Early diagnosis is essential to prevent complications, highlighting the need for improved diagnostic tools. This study aimed to identify novel Mycobacterium leprae antigens and assess their effectiveness against human sera through immunotools for antibody response evaluation. Using bioinformatics, we predicted B-cell epitopes in M. leprae, which were chemically synthesized and tested via dot blotting with sera from leprosy patients, tuberculosis patients, and healthy controls. Promising peptides underwent further analysis through ELISA using 465 serum samples from leprosy patients, household contacts, and healthy controls across Brazil. The samples were also tested against known antigens HSA-NDO, LID-1, and NDO-LID. A total of 102 epitope sequences were generated, of which eight (PEP1 to PEP8) demonstrated the ability to differentiate between individuals with and without exposure to M. leprae. The results of the ELISA test exhibited statistically significant differences in absorbance responses between the experimental groups for the novel synthetic peptides (p < 0.05). PEP3, PEP4, and PEP5 demonstrated the most favorable outcomes, with values of the area under the receiver operating characteristic curve (AUC) of 0.9759, 0.9796 and 0.9551 respectively in the comparison of healthy controls with household contacts, and 0.8257, 0.7945, and 0.7961 comparing the same controls with patients. Furthermore, the synthetic peptides demonstrated superior sensitivity, specificity, and AUC compared to HSA-NDO, LID-1, and NDO-LID. The identified peptides showed significant responses in samples from patients and household contacts (HHC), indicating their potential for tracing exposure to M. leprae bacilli. These novel synthetic peptides could enhance the sensitivity of rapid diagnostic tests for leprosy, facilitating early detection of the infection. This could help prevent disease progression and interrupt transmission.

PMID:40074449 | DOI:10.1016/j.jgeb.2025.100475

J Genet Eng Biotechnol. 2025 Mar;23(1):100462. doi: 10.1016/j.jgeb.2025.100462. Epub 2025 Feb 1.

ABSTRACT

The study aims to evaluate the significant role of interleukin 15 (IL-15), IL-22, IL-37, and Caspase 9 gene expression in polycystic ovary syndrome (PCOS), focusing on the underlying mechanisms and potential diagnostic or therapeutic implications. Peripheral blood has been collected, and serum was separated for the evaluation of the serum IL-15, IL-22, and IL-37. The ELISA technique has been carried out to determine the serum levels of understudied factors mentioned above in Iraqi women patients diagnosed with PCOS (No. = 90) via a specialized gynecologist and healthy fertile women (No. = 48) as a control group. In addition, a genetic study on the expression of the caspase 9 gene in these patients had been performed. The data reveals statistically significant differences in interleukin levels in PCOS patients versus the control group. Specifically, the PCOS group exhibits significantly higher levels of IL-15 and IL-22 as compared to the control group. Conversely, the PCOS group shows significantly lower levels of IL-37 compared to the control group. The results showed no statistically significant difference in the mean expression of the Caspase 9 gene when comparing these fold graduations. However, it’s worth noting that a higher fold frequency was observed in both the PCOS and control groups, with 57.1 % and 60 %, respectively, having folds less than 1. The distribution of folds varied across other categories was also addressed. Additionally, there was a notable difference in the frequency of 11.4 % in the PCOS group compared to 2 % in the control group for folds greater than 9. The findings suggest that interleukins, particularly IL-22 and IL-37, hold promise as diagnostic markers for distinguishing PCOS from healthy conditions. However, the potential diagnostic utility of the Caspase 9 gene expression was not confirmed in this study.

PMID:40074436 | DOI:10.1016/j.jgeb.2025.100462

Handb Clin Neurol. 2025;208:369-378. doi: 10.1016/B978-0-443-15646-5.00005-1.

ABSTRACT

The cerebellum is a subcortical structure tucked underneath the cerebrum that contains the majority of neurons in the brain, despite its small size. While it has received less attention in the study of brain asymmetries than the cerebrum, structural asymmetries in the cerebellum have been found in cerebellar volume that mirror cerebral asymmetries. Larger cerebellar structures have been reported on the right compared to the left, either for the whole cerebellar hemisphere or the anterior part of the cerebellum, with the latter accompanied by a left increase in the posterior cerebellum. Cerebellar asymmetries are considered evolutionary recent and have been observed prenatally and in early development. Both asymmetries in anterior-posterior divisions and specific lobules have been linked to handedness and cognitive abilities, in particular language. Functional lateralization in the cerebellum varies across motor and cognitive functions, with language activation predominantly localized in the right hemisphere, contralateral to cerebral activation. Meanwhile, working memory and executive functions are not lateralized to one hemisphere. New neuroimaging methods and resources, including a symmetric functional atlas of the cerebellum that enables precision mapping, open novel avenues for exploring cerebellar asymmetries and answering questions about the developmental timeline, relationships to behavior, and clinical relevance.

PMID:40074407 | DOI:10.1016/B978-0-443-15646-5.00005-1

J Prof Nurs. 2025 Mar-Apr;57:92-99. doi: 10.1016/j.profnurs.2025.01.009. Epub 2025 Jan 28.

ABSTRACT

BACKGROUND: Approximately 9 % of nursing faculty are Black (National League for Nursing, 2020). Black faculty seldom seek tenure and promotion. Tenure and promotion represent a professional and academic accomplishment, reflecting a scholar’s ability to achieve success in research, teaching, and service.

PURPOSE: The purpose of this research was to explore how Black nursing faculty described their experiences in working to earn tenure and promotion.

METHODS: Using a qualitative descriptive design, we used email surveys for data collection. We recruited tenured and tenure-track participants who were of African descent from the American Association of Colleges of Nursing and Association of Black Nursing Faculty.

RESULTS: A total of 42 participants were included in the study. We identified three major themes: Mixed Support System, Inequities, and Mentoring.

CONCLUSIONS: Even though there are some similarities with their White counterparts, Black nursing faculty may face additional challenges such as “tokenism,” inconsistent support (internally adequate, internally inadequate, internally absent, and external), and microaggressions.

PMID:40074387 | DOI:10.1016/j.profnurs.2025.01.009

J Prof Nurs. 2025 Mar-Apr;57:60-67. doi: 10.1016/j.profnurs.2025.01.005. Epub 2025 Jan 27.

ABSTRACT

BACKGROUND: Challenges arising from the COVID-19 pandemic and social injustice complicated the nursing workforce, nursing education, and personal life inequities faced by Doctor of Philosophy (PhD) in Nursing students from historically marginalized and minoritized communities (MMC). This article describes the process of forming a PhD in Nursing Student-Led Diversity, Equity, and Inclusion (DEI) Advisory Council to address these inequities.

METHODS: The authors provide a blueprint for developing a similar group through supporting research and experiences.

RESULTS: The group developed and worked towards their mission to “strengthen diversity, equity, inclusion, and justice in nursing science and research through scholarship, community-building and advocacy.”

CONCLUSION: A student-led DEI advisory group is a great way to establish a community for nursing students at a high risk for isolation and stress and improve retention of students, especially those from MMC.

PMID:40074382 | DOI:10.1016/j.profnurs.2025.01.005

J Prof Nurs. 2025 Mar-Apr;57:121-128. doi: 10.1016/j.profnurs.2025.01.010. Epub 2025 Feb 3.

ABSTRACT

BACKGROUND: Social support is a crucial factor in mitigating psychological distress among nursing students. However, the specific mechanism through which social support influences psychological distress, particularly the mediating role of school-life interference, remains underexplored. Aim The researchers investigated the relationship between social support and psychological distress in nursing students and examined the extent to which school-life interference mediates this relationship.

METHODS: A cross-sectional research design was employed. Data were collected from 1014 nursing students from three government universities in the Philippines. Three standardized scales were used: the Perceived Social Support Questionnaire (PSSQ), School-Life Interference Scale (SLIS), and the Perceived Stress Scale (PSS). Descriptive statistics, correlation analysis, and mediation analysis were conducted to analyze the data.

RESULTS: The findings revealed a moderate level of perceived social support (M = 3.554, SD = 0.775), high levels of school-life interference (M = 3.923, SD = 0.638), and significant psychological distress (M = 3.505, SD = 0.808). Social support was negatively associated with psychological distress (β = -0.1547, p < 0.001) and school-life interference (β = -0.0829, p = 0.001). School-life interference partially mediated the relationship between social support and psychological distress (β = -0.0375, LLCI = -0.0633 to ULCI = -0.0126).

CONCLUSION: Social support played a crucial role in mitigating school-life interference, which subsequently reduced psychological distress among nursing students. Furthermore, the interventions aimed at enhancing social support and reducing school-life interference should be integrated into nursing education programs to support students’ psychological well-being and academic success.

PMID:40074374 | DOI:10.1016/j.profnurs.2025.01.010

Br J Nutr. 2025 Mar 13:1-33. doi: 10.1017/S0007114525000509. Online ahead of print.

ABSTRACT

Low vitamin D associated with high parathyroid hormone (PTH) is commonly reported in the context of HIV infection. We determined the association between total 25-hydroxyvitamin-D [25(OH)D] and PTH in adolescents living with HIV, in Zambia and Zimbabwe. Adolescents (11-19 years) perinatally-infected with HIV and established on antiretroviral therapy (ART) for ≥6 months were recruited into a cross-sectional study. Socio-demographic and clinical characteristics were recorded, anthropometry measured, and fasted serum concentrations of 1,25-dihydroxyvitamin-D (1,25(OH)₂D), total 25(OH)D and intact PTH measured. The association between total 25(OH)D and PTH was examined using natural cubic spline regression modelling. 842 participants (female: 53.2%) with median age 15.5 (IQR:13.2-17.9) years were enrolled. Median ART duration was 9.8 [IQR:6.3-12.3] years and 165/841 (19.6%) had an HIV viral load >60copies/ml. Stunting (HAZ score<-2) and underweight (WAZ score<-2) were observed in 29.9% and 30.0% respectively. Three quarters (n=639) reported daily calcium intakes <150mg/day. The mean (SD) concentrations of total 25(OH)D and 1,25(OH)₂D were 66.1(16.5) nmol/L and 210.6(70.4) pmol/L respectively, and median PTH level was 4.3 (IQR:3.3-5.5) pmol/L. There was an inverse non-linear relationship between total 25(OH)D and PTH, 25(OH)D levelling-off at 74.6nmol/L (95%CI: 74.5-75.2). Results were consistent in those taking tenofovir disoproxil fumarate (81.7%) and in those who were virally unsuppressed. In this population with extremely low habitual calcium intakes, the lack of association between 25(OH)D and PTH when 25(OH)D exceeded 75nmol/L, potentially suggests levels of 25(OH)D >75nmol/l may need to be achieved to improve bone health; investigation is needed in future research studies.

PMID:40074367 | DOI:10.1017/S0007114525000509

Environ Health Prev Med. 2025;30:16. doi: 10.1265/ehpm.24-00373.

ABSTRACT

BACKGROUND: There is growing evidence that the occurrence and severity of respiratory diseases in children are related to the concentration of air pollutants. Nonetheless, evidence regarding the association between short-term exposure to air pollution and outpatient visits for respiratory diseases in children remains limited. Outpatients cover a wide range of disease severity, including both severe and mild cases, some of which may need to be transferred to inpatient treatment. This study aimed to quantitatively evaluate the impact of short-term ambient air pollution exposure on outpatient visits for respiratory conditions in children.

METHODS: This study employed data of the Second People’s Hospital of Yichang from January 1, 2016 to December 31, 2023, to conduct a time series analysis. The DLNM approach was integrated with a generalized additive model to examine the daily outpatient visits of pediatric patients with respiratory illnesses in hospital, alongside air pollution data obtained from monitoring stations. Adjustments were made for long-term trends, meteorological variables, and other influencing factors.

RESULTS: A nonlinear association was identified between PM_2.5, PM₁₀, O₃, NO₂, SO₂, CO levels and the daily outpatient visits for respiratory diseases among children. All six pollutants exhibit a hysteresis impact, with varying durations ranging from 4 to 6 days. The risks associated with air pollutants differ across various categories of children’s respiratory diseases; notably, O₃ and CO do not show statistical significance concerning the risk of chronic respiratory conditions. Furthermore, the results of infectious respiratory diseases were similar with those of respiratory diseases.

CONCLUSIONS: Our results indicated that short-term exposure to air pollutants may contribute to an increased incidence of outpatient visits for respiratory illnesses among children, and controlling air pollution is important to protect children’s health.

PMID:40074352 | DOI:10.1265/ehpm.24-00373

Circ J. 2025 Mar 11. doi: 10.1253/circj.CJ-24-0939. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this was to develop an atrial fibrillation (AF) risk score using items usually included in Japanese governmental health check-ups.

METHODS AND RESULTS: We analyzed data from 6,476 Japanese participants registered in the Suita Study. At baseline, the participants were aged ≥30 years and were free from AF. Cox regression analysis was used to identify AF risk factors, and a 0-100 score was developed to predict AF events within 10 years. Within a median follow-up of 14.6 years, 278 participants developed AF. The risk score incorporated age [<50 years (16 points for men, 0 for women), 50-59 years (26 points for men, 14 for women), 60-69 years (41 points for men, 37 for women), ≥70 years (54 points for men, 51 for women)], current smoking with a smoking index >500 (7 points), heavy alcohol consumption (8 points), body mass index ≥25 kg/m²(6 points), hypertension (7 points), urinary proteins (4 points), glutamic-pyruvic transaminase >50 IU/dL (4 points), and cardiovascular disease history (10 points). The 10-year AF event probabilities were 7.1%, 8.4%, 10.8%, and 15.9% for scores of 47-54, 55-58, 59-69, and ≥70, respectively.

CONCLUSIONS: The new risk score to predict AF uses items similar to those used in Japanese governmental health check-ups.

PMID:40074343 | DOI:10.1253/circj.CJ-24-0939