Nevin Manimala

BMC Nurs. 2026 May 14. doi: 10.1186/s12912-026-04723-8. Online ahead of print.

ABSTRACT

AIM/OBJECTIVE: This study aimed to examine the role of perceived academic mentorship and self-efficacy in enhancing self-directed learning readiness (SDLR) among undergraduate nursing students.

BACKGROUND: Self-directed learning readiness is essential for nursing students to effectively manage their learning in complex and evolving healthcare environments. While academic mentorship and self-efficacy have been associated with learning outcomes, their combined relationships with SDLR remain insufficiently explored.

METHODS: A descriptive correlational cross-sectional design was used. Data were collected from 500 undergraduate nursing students at the Faculty of Nursing, Damanhour University, Egypt, during the 2025-2026 academic year. Data were collected using three validated self-report scales measuring perceived academic mentorship, self-directed learning readiness, and self-efficacy. Data were analyzed using descriptive statistics, correlation, regression, and mediation analysis.

RESULTS: Perceived academic mentorship showed moderate positive correlations with self-directed learning readiness (r = 0.48, p < 0.01) and self-efficacy (r = 0.52, p < 0.01), while self-efficacy was also positively correlated with SDLR (r = 0.46, p < 0.01). Regression analysis indicated that demographic and academic variables explained 26.9% of the variance in SDLR. Mediation analysis revealed that self-efficacy partially mediated the relationship between perceived academic mentorship and SDLR (β = 0.15, 95% CI [0.10-0.20]).

CONCLUSIONS: The findings indicate that students’ readiness for self-directed learning is not shaped by academic mentorship alone, but by how mentorship experiences translate into stronger beliefs in their ability to manage learning demands. This suggests that efforts to enhance students’ readiness for self-directed learning should prioritize mentorship approaches that move beyond guidance alone toward intentionally fostering students’ confidence, independence, and engagement in their learning processes.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42135737 | DOI:10.1186/s12912-026-04723-8

BMC Surg. 2026 May 14. doi: 10.1186/s12893-026-03819-x. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative abdominal wall dehiscence (AWD) or burst abdomen (BA) is a relevant complication after abdominal surgery that causes additional surgical procedures, prolonged hospital stays and long-term morbidity. Several underlying risk factors exist and have been described in literature and consist of surgical and medical factors. Recently, CT-derived body composition is of rising interest to provide new prognostic factors in surgical patients. The present study aims to explore the association between CT-defined body composition and postoperative BA.

MATERIALS AND METHODS: A database of patients who underwent abdominal surgery and developed post-operative wound infections in our institution between 2015 and 2018, was assembled. The subgroup of patients with BA was compared to a control group without BA. CT-defined body composition was evaluated in L3-level measuring skeletal muscle index (SMI) for sarcopenia assessment, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Clinical risk factors and CT-defined body composition were used to predict the occurrence of postoperative BA using discriminatory and binary logistic regression analyses.

RESULTS: A total of 118 patients, 92 (78%) with BA and 26 (22%) without BA were included in the analysis. CT derived body composition parameters for visceral obesity and sarcopenia showed statistically significant differences between the two cohorts. Patients with burst abdomen showed higher VAT (157.6 cm² vs. 84.9 cm², p = 0.001) and a significantly lower SMI (46.9 cm²/m² vs. 53.8 cm²/m², p = 0.016). Consequently, visceral obesity and sarcopenia were significantly more frequent in patients with BA (p = 0.02 and 0.01, respectively). In the multivariable Firth’s penalized logistic regression, visceral obesity (OR = 4.87, 95% CI 1.32-21.91 p = 0.02), sarcopenia (OR = 5.94, 95% CI 1.65-26.68 p = 0.006), intestinal resection (OR = 9.33, 95% CI 2.33-55.65 p < 0.001) and length of the surgical wound (OR = 1.12, 95% CI 1.04-1.22 p = 0.001) were independently associated with the occurrence of burst abdomen.

CONCLUSION: CT-defined body composition with sarcopenia and visceral obesity are strongly associated with postoperative BA. This analysis should be further acknowledged as a potentially important risk factor in surgical care and could aid in clinical decision making.

PMID:42135717 | DOI:10.1186/s12893-026-03819-x

J Cardiothorac Surg. 2026 May 14. doi: 10.1186/s13019-026-04094-w. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is a critical condition that leads to significant morbidity and mortality. Accurate prediction of patient outcomes is essential for effective management. This meta-analysis evaluates the prognostic value of echocardiographic cardiac function parameters, particularly left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LVGLS), in predicting short-term outcomes in sepsis patients.

METHODS: A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted from inception to January 19, 2026, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort studies assessing echocardiographic parameters and short-term mortality in adult sepsis were included. Random-effects meta-analysis was performed using standardized mean differences (SMDs). Sensitivity analyses included leave-one-out procedures and restricted maximum likelihood with Hartung-Knapp adjustment. Publication bias was evaluated using funnel plots and Egger’s regression test.

RESULTS: Nine cohort studies published between 2014 and 2021 were included. LVGLS was significantly more impaired in non-survivors than in survivors (SMD – 0.40, 95% confidence interval [CI] – 0.62 to – 0.18; I² = 51.1%). Results remained robust with Hartung-Knapp adjustment (SMD – 0.55, 95% CI – 0.79 to – 0.30). In a septic shock-only sensitivity analysis, the association persisted (SMD – 0.76, 95% CI – 1.01 to – 0.51; I² = 0%). Subgroup analysis showed no significant difference between Sepsis-2 and Sepsis-3 studies (P = 0.45). LVEF was not associated with short-term mortality (SMD 0.06, 95% CI – 0.08 to 0.20; I² = 27.2%). Funnel plot inspection showed no clear asymmetry, and Egger’s test was not statistically significant.

CONCLUSIONS: LVGLS is associated with short-term mortality in sepsis and may provide incremental prognostic information beyond conventional LVEF assessment. Prospective studies are needed to define clinically meaningful thresholds and evaluate incremental value over established risk scores.

PMID:42135714 | DOI:10.1186/s13019-026-04094-w

Immunobiology. 2026 May 12;231(3):153187. doi: 10.1016/j.imbio.2026.153187. Online ahead of print.

ABSTRACT

Despite the proliferation of prognostic gene signatures for glioma, clinical translation remains stalled by poor reproducibility and overfitting. In this study, we address this stability crisis by developing a robust “Dual-Signature Framework” using stability selection-a rigorous resampling method-rather than standard regression. Analyzing RNA-seq data from 1351 patients across the TCGA (n = 694) and CGGA (n = 657) cohorts, we constructed two distinct models. The primary 20-gene “Data-Driven” signature achieved superior predictive accuracy (C-index: 0.7392), significantly outperforming 14 published benchmark models and the current best single-gene predictor (HOXA5). In parallel, we derived a 7-gene “Biology-Driven” signature (including HOXA5, CHI3L1, MMP14) that retained 98% of the predictive power (C-index: 0.7252) while prioritizing mechanistic interpretability. Both models successfully stratified patients into distinct risk groups with high statistical significance (Log-rank p < 0.001) in external validation. Comprehensive subgroup analyses across 19 clinical and molecular subgroups demonstrated robust performance (C-index range: 0.59-0.85), with extended calibration analysis confirming excellent probability estimation (Brier score 0.20 for 5-year predictions). By integrating stability-driven feature selection with biological pathway constraints, this study provides a reproducible, high-performance alternative to unstable “black box” models, offering a translation-ready tool for personalized glioma risk assessment.

PMID:42134029 | DOI:10.1016/j.imbio.2026.153187

Am J Public Health. 2026 May 14:e1-e4. doi: 10.2105/AJPH.2026.308528. Online ahead of print.

ABSTRACT

Objectives. To describe mortality rates by occupation among working-age men in the United States in 2022 and 2023. Methods. I obtained data on the occupation of decedents from death certificate data published by the National Center for Health Statistics for men aged 20 to 64 years. I calculated mortality rates and rate ratios for occupation groups. Results. Mortality rates were more than double for construction and extraction workers compared with all other workers. Mortality rates and rate ratios for workers in manual, blue-collar occupations were significantly higher than those for workers in other occupations. Conclusions. There were notably higher mortality rates for workers in manual, blue-collar occupations. Occupation groups with higher mortality rates also generally had a larger share of men in their workforce. Public Health Implications. Further research should examine work-related risk factors for occupational disparities in all-cause mortality. The workplace can be a convenient setting for interventions to prevent premature death among working-age men. Including occupation at the time of death in public health data can improve the validity and precision of future studies of the occupational causes of mortality. (Am J Public Health. Published online ahead of print May 14, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308528).

PMID:42133997 | DOI:10.2105/AJPH.2026.308528

Genome. 2026 May 14. doi: 10.1139/gen-2025-0065. Online ahead of print.

ABSTRACT

Human-mediated change has resulted in the expansion of many species into novel habitats. Range expansions have been described demographically as either pulled or pushed, depending on the number of individuals on the leading front, and can leave distinct genomic signatures within the genome. The recent expansions of Agrilus planipennis, Lycorma delicatula, and Dendroctonus ponderosae represent different types of range expansion which can be analyzed by coupling rigorous monitoring of recent expansions with whole-genome assemblies to provide a strong comparative framework with which to study the genomic signatures of expansion type. Here, we synthesize range expansion theory in the context of these recent expansions and generate hypotheses on the expected patterns of genomic change. We then outline statistical and genome-structural methods that can be used to identify putatively adaptive loci, leveraging the increased genomic resolution provided by whole-genome assemblies. Finally, we complement the overarching expansion hypotheses with a discussion of using a top-down approach to identify loci under selection, using cold tolerance traits as an example. With these methods we can better understand the risk of further spread and persistence of these expanding insect populations, as well as establish a framework for quantifying the adaptive potential of other expanding species.

PMID:42133990 | DOI:10.1139/gen-2025-0065

JMIR Mhealth Uhealth. 2026 May 14;14:e77778. doi: 10.2196/77778.

ABSTRACT

BACKGROUND: Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.

OBJECTIVE: This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities where they practiced during the COVID-19 pandemic.

METHODS: A population-based cross-sectional survey was administered in 2021 by the MD Anderson Cancer Center to HCPs working in Texas using email addresses obtained from the LexisNexis Master Provider Referential Database. HCPs were asked if they assessed HPV vaccination status during every patient encounter. Those who responded “Often/Always” or “Sometimes” were subsequently asked whether they observed any change (“Decreased,” “No change,” “Increased,” or “Not sure”) in HPV vaccine hesitancy during the COVID-19 pandemic. Additionally, HCPs were asked whether their practice offers HPV vaccination. Those who responded “Yes” to this question were further asked whether vaccination-related applications are promoted at the facility where they practice, with response options being “Yes,” “No,” or “I don’t know.” Logistic regression analysis was performed to examine the association between changes in HPV vaccine hesitancy observed by HCPs and promotion of vaccination-related applications at the facility where they practice.

RESULTS: A total of 1283 HCPs completed the survey. Of the 730 HCPs who observed changes in HPV vaccine hesitancy, 51 (7%) reported a decrease in their patients’ HPV vaccine hesitancy. Of these 730 HCPs, 578 (79.2%) responded to the questions regarding vaccination-related applications, of whom 104 (18%) reported that vaccination-related applications were promoted at their facilities. Compared to HCPs who reported not promoting vaccination-related applications, those who reported doing so at their facilities had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients (adjusted odds ratio [aOR] 2.48, 95% CI 1.10-5.55; P=.03). HCPs working at federally qualified health centers or city, county, or public health care facilities (aOR 4.02, 95% CI 1.33-12.14; P=.01) and HCPs who administered the HPV vaccine under standing orders at their facilities (aOR 2.91, 95% CI 1.11-7.63; P=.03) had significantly higher odds of observing a decrease in HPV vaccine hesitancy at their practices.

CONCLUSIONS: Our findings suggest that promoting vaccination-related applications at health care facilities in areas with high HPV vaccine hesitancy such as Texas could further decrease HPV vaccine hesitancy in the population. This may be potentially applicable across diverse health care settings, particularly in the context of pandemic preparedness.

PMID:42133976 | DOI:10.2196/77778

JMIR Public Health Surveill. 2026 May 14;12:e86435. doi: 10.2196/86435.

ABSTRACT

BACKGROUND: Although health care providers are the most trusted sources of health information, service establishments within communities represent important, yet underused, sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communication, facilitating broader engagement with the general population.

OBJECTIVE: This study examined factors associated with willingness to receive health information from these non-health care service establishments among community-dwelling adults in Singapore.

METHODS: A cross-sectional survey was conducted among residents in 2 neighborhoods in central Singapore between November 2024 and April 2025. Data on sociodemographic characteristics, trust in information from health care and non-health care services, and willingness to receive health information were collected anonymously. The primary outcome was willingness to receive health information from non-health care services (yes or no), assessed among respondents with no prior exposure to health information from such services. Multivariable logistic regression was used to identify factors independently associated with willingness to receive health information from non-health care services.

RESULTS: Among the 403 respondents, most were aged ≥50 years (n=223, 55.3%), female (n=219, 54.3%), Chinese (n=350, 86.9%), and highly educated (n=302, 74.9%). Of the 339 respondents without prior exposure to health information from non-health care services, approximately one-third (n=106, 31.3%) reported that they were willing to receive health information in the future. In adjusted analysis, greater trust in health information (adjusted odds ratio [AOR] 3.71, 95% CI 1.50-9.19) and high health information orientation (AOR 1.89, 95% CI 1.11-3.21) were associated with increased willingness to receive health information from non-health care services. Trust in health information was positively associated with willingness among those aged 21 to 34 years (AOR 4.96, 95% CI 1.35-18.30), those aged 35 to 49 years (AOR 8.02, 95% CI 2.62-24.59), and male respondents (AOR 6.22, 95% CI 2.79-13.89) to receive health information from these sources, but not among those aged ≥50 years (AOR 1.92, 95% CI 0.92-4.02) or female respondents (AOR 1.85, 95% CI 0.87-3.96).

CONCLUSIONS: Nearly one-third of community-dwelling adults expressed willingness to receive health information from non-health care (food and beauty) services, highlighting the potential for leveraging these establishments as alternative health communication channels. Willingness was positively associated with higher health information orientation and greater trust. Additionally, trust in non-health care (food and beauty) services was associated with higher odds of willingness to receive health information among those aged 21 to 49 years and male respondents. This suggests the need for tailored trust-building strategies to strengthen engagement through such alternative channels.

PMID:42133973 | DOI:10.2196/86435

J Neuroophthalmol. 2026 Jun 1;46(2):271-278. doi: 10.1097/WNO.0000000000002481.

ABSTRACT

BACKGROUND: The Idiopathic Intracranial Hypertension Treatment Trial’s (IIHTT) objective was to evaluate the efficacy and safety of acetazolamide, combined with a low-sodium weight-reduction diet, in improving visual function in patients with idiopathic intracranial hypertension (IIH) and mild visual loss.

METHODS: To accomplish this, a NEI-sponsored multicenter, double-blind, randomized, placebo-controlled clinical trial was performed at 38 North American clinical sites. A total of 165 participants (161 women; mean age 29 years) meeting the modified Dandy criteria with reproducible mild visual loss (perimetric mean deviation [PMD] -2 to -7 dB) were enrolled. Participants were randomized to acetazolamide or placebo, each combined with a structured dietary program. Acetazolamide was initiated at 1 g/day and titrated weekly to a maximum of 4 g/day. The primary outcome was change in PMD at 6 months. Treatment failure was defined by prespecified reproducible PMD worsening criteria. Secondary outcomes included papilledema grade, OCT metrics, cerebrospinal fluid (CSF) pressure, quality of life, weight change, and headache disability.

RESULTS: Acetazolamide produced greater PMD improvement than placebo (1.43 dB vs 0.71 dB; treatment effect 0.71 dB; P = 0.05) and the result was independent of weight loss. Participants with high-grade papilledema had the greatest benefit (2.27 dB). Acetazolamide significantly improved papilledema grade and OCT optic disc volume and reduced CSF pressure by an additional 60-mm H2O compared with placebo (P = 0.002). Quality-of-life scores improved significantly with improvement in vision being the most important factor. Seven participants experienced treatment failure (6 placebo, 1 acetazolamide). Risk factors for treatment failure were high-grade papilledema, more than 30 transient visual obscurations per month, visual acuity loss, and male sex. Compliance of study drug was high (89% vs 93%). Tolerability was excellent when the maximal tolerated dosage was used with no permanent morbidity.

CONCLUSIONS: Acetazolamide plus diet gave statistically significant improvements of visual function, papilledema, CSF pressure, and quality of life in patients with IIH with mild visual loss. A maximally tolerated dose up to 4 g/day is recommended.

PMID:42133960 | DOI:10.1097/WNO.0000000000002481

Obstet Gynecol. 2026 May 15. doi: 10.1097/AOG.0000000000006320. Online ahead of print.

ABSTRACT

OBJECTIVE: The New York State Safe Motherhood Initiative, a statewide quality-improvement effort, developed a bundle to optimize management of obstetric hemorrhage that was then disseminated and implemented by many hospitals in New York State. The purpose of this study was to evaluate trends in statewide outcomes related to postpartum hemorrhage (PPH) before, during, and after Safe Motherhood Initiative obstetric hemorrhage bundle implementation.

METHODS: Delivery hospitalizations in the 2007-2022 New York State Inpatient Database were analyzed for this repeated ecologic cross-sectional analysis that evaluated outcomes before and after implementation of the Safe Motherhood Initiative obstetric hemorrhage bundle from 2013 to 2015. The New York State Inpatient Database includes discharge data for all inpatient acute care hospitalizations in New York. Trends analysis of PPH diagnoses among all delivery hospitalizations over the study period was first performed. Then, among deliveries complicated by PPH, the rate of the following adverse outcomes was determined by year: 1) transfusion, 2) nontransfusion severe maternal morbidity (SMM), 3) disseminated intravascular coagulation (DIC), and 4) hysterectomy. Analyses were performed with joinpoint regression to determine the average annual percent change (AAPC). Adjusted logistic regression models were additionally performed for each of the adverse outcomes.

RESULTS: Among 3,563,885 delivery hospitalizations, PPH increased continuously from 22 per 1,000 in 2007 to 59 per 1,000 in 2022 (AAPC 6.9%, 95% CI, 6.5-7.5%). In joinpoint analysis, transfusion among delivering patients with PPH increased from 192 per 1,000 in 2007 to 212 per 1,000 in 2013 (AAPC 2.1%, 95% CI, 0.6-6.6%) but then decreased to 174 per 1,000 in 2016 (AAPC -6.8%, 95% CI, -9.5% to -2.1%) before increasing again to 212 per 1,000 in 2022 (AAPC 2.8%, 95% CI, 1.2-8.1%). Severe maternal morbidity increased from 88 per 1,000 in 2007 to 122 per 1,000 in 2014 (AAPC 2.8%, 95% CI, 0.7-7.6%) before decreasing to 76 per 1,000 in 2017 (AAPC -16.3%, 95% CI, -20.8% to -8.4%) before rising again to 88 per 1,000 in 2022 (AAPC 4.4%, 95% CI, 0.1-18.5%). Disseminated intravascular coagulation increased from 54 per 1,000 in 2007 to 90 per 1,000 in 2014 (AAPC 4.5%, 95% CI, 1.3-12.6%), decreased to 53 per 1,000 in 2017 (AAPC -19.3%, 95% CI, -25.3% to -8.9%), and increased without a significant statistical association to 88 per 1,000 in 2022 (AAPC 4.2%, 95% CI, -2.0% to 24.5%). Hysterectomy decreased significantly from 26 per 1,000 in 2013 to 9 per 1,000 in 2022 (AAPC -10.2%, 95% CI, -14.3% to -8.7%). In logistic regression analysis, adjusted odds of severe morbidity from 2016 to 2022 were decreased compared with 2007 after accounting for patient- and hospital-level factors.

CONCLUSION: The initiation of the New York Safe Motherhood Initiative obstetric hemorrhage bundle coincided with decreased risk for a range of adverse outcomes among deliveries complicated by PPH. Decreases in risk continued for approximately 3-4 years after initiation of the program for SMM, DIC, and transfusion. In comparison, hysterectomy decreased continuously until the end of the study period. Case mix and worsening comorbidity may have accounted for later study trends given that adjusted regression models for SMM demonstrated decreased odds of peripartum hysterectomy over the later portion of the study.

PMID:42133948 | DOI:10.1097/AOG.0000000000006320