Nevin Manimala

Asian Pac Isl Nurs J. 2025 Aug 11;9:e75432. doi: 10.2196/75432.

ABSTRACT

BACKGROUND: Nursing is an emotionally demanding profession where unmanaged anger can compromise patient care and teamwork. While clinical experience is thought to enhance emotional regulation, the relationship between work experience and anger management remains poorly understood.

OBJECTIVE: This study aimed to assess whether work experience predicts anger management ability among nurses, using Benner’s Novice to Expert Theory as a guiding framework.

METHODS: A descriptive cross-sectional study was conducted in 2024 involving 265 nurses working in hospitals affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran. Stratified random sampling was used based on hospital wards. Data were collected using a demographic questionnaire and the State-Trait Anger Expression Inventory-2. Statistical analyses included Pearson correlation analysis, t tests, ANOVA, and multiple linear regression analysis. Normality was tested using the Kolmogorov-Smirnov test. The sample size was determined using parameters referenced in prior studies and confirmed with G*Power software (Heinrich-Heine-University Düsseldorf).

RESULTS: Although nurses with more experience reported slightly higher anger control scores, the correlation between work experience and anger management was not significant (r=-0.079, P=.18). Regression analysis revealed that shift type and job security significantly predicted anger regulation, independent of experience level.

CONCLUSIONS: Work experience alone does not ensure improved anger management among nurses. Organizational factors such as shift scheduling and employment stability may have a greater influence on emotional regulation. Institutions are encouraged to provide structured support and stress management training, especially for early-career nurses.

PMID:40789152 | DOI:10.2196/75432

JBRA Assist Reprod. 2025 May 29. doi: 10.5935/1518-0557.20250004. Online ahead of print.

ABSTRACT

OBJECTIVE: Salpingectomy has been one of the most performed surgical procedures in gynecological practice worldwide. Common indications include ectopic pregnancy and salpingitis (for example symptomatic hydro or pyosalpinx). This rising trend in salpingectomy has been associated with a rising concern over its potentially damaging effect on ovarian reserve due to possible concomitant damage of ovarian blood supply given the proximity of tubal and ovarian arteries.

METHODS: This is a prospective cohort Study including eighty cases of infertile women with a previous unilateral or bilateral hydro salpinx and indicated for salpingectomy or tubal ligation attending the outpatient clinic at assisted reproduction unit, Al-Azhar University. The results were obtained in the period from February 2020 to December 2022.

RESULTS: The present study was conducted on 80 patients. The mean and (SD) values for age were 25.5 (5.2) years old with a minimum of 18 and a maximum of 34 years old. More than half of patients (58.8%) had bilateral Hydrosalpinx while 41.2% had unilateral hydrosalpinx. Whether preor post-operatively, there was no statistically significant difference between median number of antral follicles in patients with unilateral and bilateral hydrosalpinx. There was no statistically significant change in the mean of AMH levels post-operatively (p-value=0.147, effect size=0.035) in both unilateral and bilateral groups. There was no statistically significant change in median number of Antral follicles post-operatively (p-value=0.456, Effect size=0.167) in both unilateral and bilateral groups.

CONCLUSIONS: The unilateral and bilateral salpingectomy in patients with normal ovaries has no detrimental effect on ovarian reserve.

PMID:40789151 | DOI:10.5935/1518-0557.20250004

JMIR Form Res. 2025 Aug 11;9:e68666. doi: 10.2196/68666.

ABSTRACT

BACKGROUND: Systematic reviews are essential for synthesizing research in health sciences; however, they are resource-intensive and prone to human error. The data extraction phase, in which key details of studies are identified and recorded in a systematic manner, may benefit from the application of automation processes. Recent advancements in artificial intelligence, specifically in large language models (LLMs) such as ChatGPT, may streamline this process.

OBJECTIVE: This study aimed to develop and evaluate a custom Generative Pre-Training Transformer (GPT), named Systematic Review Extractor Pro, for automating the data extraction phase of systematic reviews in health research.

METHODS: OpenAI’s GPT Builder was used to create a GPT tailored to extract information from academic manuscripts. The Role, Instruction, Steps, End goal, and Narrowing (RISEN) framework was used to inform prompt engineering for the GPT. A sample of 20 studies from two distinct systematic reviews was used to evaluate the GPT’s performance in extraction. Agreement rates between the GPT outputs and human reviewers were calculated for each study subsection.

RESULTS: The mean time for human data extraction was 36 minutes per study, compared to 26.6 seconds for GPT generation, followed by 13 minutes of human review. The GPT demonstrated high overall agreement rates with human reviewers, achieving 91.45% for review 1 and 89.31% for review 2. It was particularly accurate in extracting study characteristics (review 1: 95.25%; review 2: 90.83%) and participant characteristics (review 1: 95.03%; review 2: 90.00%), with lower performance observed in more complex areas such as methodological characteristics (87.07%) and statistical results (77.50%). The GPT correctly extracted data in 14 instances (3.25% in review 1) and four instances (1.16% in review 2) when the human reviewer was incorrect.

CONCLUSIONS: The custom GPT significantly reduced extraction time and shows evidence that it can extract data with high accuracy, particularly for participant and study characteristics. This tool may offer a viable option for researchers seeking to reduce resource demands during the extraction phase, although more research is needed to evaluate test-retest reliability, performance across broader review types, and accuracy in extracting statistical data. The tool developed in the current study has been made open access.

PMID:40789147 | DOI:10.2196/68666

J Chem Inf Model. 2025 Aug 11. doi: 10.1021/acs.jcim.5c01030. Online ahead of print.

ABSTRACT

Noncanonical amino acids (NCAAs) occupy an important place, both in natural biology and in synthetic applications. However, modeling these amino acids still lies outside the capabilities of most deep learning methods due to sparse training data sets for this task. Instead, biophysical methods such as Rosetta can excel in modeling NCAAs. We discuss the various aspects of parametrizing an NCAA for use in Rosetta, identifying rotamer distribution modeling as one of the most impactful factors of NCAA parametrization on Rosetta performance. To this end, we also present FakeRotLib, a method that uses statistical fitting of small-molecule conformers to create rotamer distributions. We find that FakeRotLib outperforms existing methods in a fraction of the time and is able to parametrize NCAA types previously unmodeled by Rosetta.

PMID:40789114 | DOI:10.1021/acs.jcim.5c01030

J Clin Oncol. 2025 Aug 11:JCO2500167. doi: 10.1200/JCO-25-00167. Online ahead of print.

ABSTRACT

PURPOSE: On September 17, 2024, the US Food and Drug Administration (FDA) approved ribociclib in combination with an aromatase inhibitor (AI) for the adjuvant treatment of adults with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative stage II and III early breast cancer (EBC) who are at high risk of recurrence.

PATIENTS AND METHODS: The FDA approval was based on NATALEE, a randomized (1:1), open-label, multicenter, multinational trial in adults of any sex or menopausal status with hormone receptor-positive, HER2-negative stage II and III EBC who received ribociclib plus an AI (Ribo + AI, n = 2,549) versus an AI (n = 2,552); patients also received goserelin as clinically indicated. Ribociclib was given at 400 mg once daily (3 weeks on/1 week off) for up to 36 months. AI was given per standard of care for at least 5 years. The primary end point was invasive disease-free survival (iDFS), defined according to Standardized Definitions for Efficacy End Points version 1.0 criteria. Overall survival (OS) was a secondary end point.

RESULTS: iDFS was statistically significant at the third interim analysis (IA3; January 2023; hazard ratio [HR], 0.75 [95% CI, 0.62 to 0.91]) in the intent-to treat (ITT) population. However, at IA3, there was a large amount of censoring for iDFS as only 20% of patients had completed 3 years of adjuvant therapy and OS was immature. Because of these concerns, FDA requested that NATALEE continue until the final iDFS analysis. At the final iDFS analysis, the iDFS at 36 months was 90.7% (95% CI, 89.3 to 91.8) for Ribo + AI versus 87.6% (95% CI, 86.1 to 88.9) for AI, with a HR of 0.75 (95% CI, 0.63 to 0.89). More patients who received ribociclib experienced all-grade (98% Ribo + AI v 88% AI) and grade ≥3 (64% Ribo + AI v 19% AI) adverse reactions (ARs).

CONCLUSION: Addition of adjuvant ribociclib to NSAI for adults with high-risk stage II and III hormone receptor-positive, HER2-negative EBC demonstrated a favorable benefit-risk profile with a statistically significant iDFS advantage. OS data remain immature.

PMID:40789109 | DOI:10.1200/JCO-25-00167

J Clin Oncol. 2025 Aug 11:JCO2500221. doi: 10.1200/JCO-25-00221. Online ahead of print.

ABSTRACT

PURPOSE: Hippocampal avoidance (HA) during therapeutic whole-brain radiotherapy reduces the risk of neurocognitive function (NCF) toxicity in patients with brain metastasis. This trial hypothesized that HA during prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC) leads to noninferior intracranial relapse (ICR) and reduction in NCF toxicity.

METHODS: This randomized phase II/III trial enrolled patients with SCLC, no brain metastases, and response to chemotherapy. The primary end points were 12-month ICR (noninferiority design, randomized phase II) and 6-month Hopkins Verbal Learning Test-Revised (HVLT-R) Delayed Recall (DR) failure (phase III). Secondary end points were failure in any NCF test, health-related quality of life (HRQOL), overall survival (OS), and toxicity.

RESULTS: From December 2015 to June 2022, 393 patients were randomly assigned. The median age was 64 years. Stage and memantine usage were balanced. The median follow-up was 17.0 months (all patients) and 30.8 months (alive patients). HA-PCI had noninferior 12-month ICR rate (PCI 14.8% v HA-PCI 14.7%, P < .0001). Six-month HVLT-R DR deterioration was not significantly different (PCI 30.0% v HA-PCI 25.5%, P = .28). Addition of HA to PCI reduced the risk of failure in any NCF test (adjusted hazard ratio [HR], 0.78; 95% CI [0.61 to 0.99]; P = .039). Addition of HA to PCI was not associated with longitudinal change in any HRQOL domain. There were no differences in OS (adjusted HR, 0.88 [95% CI, 0.67 to 1.14]; P = .33) or grade ≥3 toxicity (PCI 31.4% v HA-PCI 30.7%, P = .88).

CONCLUSION: Although the study did not meet its primary end point of DR preservation, HA during PCI reduces the risk of overall neurocognitive toxicity with noninferior ICR risk and similar survival.

PMID:40789106 | DOI:10.1200/JCO-25-00221

Neurology. 2025 Sep 9;105(5):e213983. doi: 10.1212/WNL.0000000000213983. Epub 2025 Aug 11.

ABSTRACT

BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) is associated with increased risk of both death and dementia in older adults, but no prognostic models currently exist to help identify which individuals are at greatest risk of long-term adverse outcomes. Our primary objective was to develop a single prognostic model that uses electronic health record (EHR) data to predict 5-year risk of dementia or death in older veterans who have experienced TBI.

METHODS: We performed a retrospective cohort study using EHR data from the US Department of Veterans Affairs Health Care System. Participants were US veterans aged 55 years or older without dementia who had a TBI diagnosis and received care between 2002 and 2019. Potential predictor variables included demographics, medical comorbidities, mental health conditions, and health care utilization factors. We used multinomial logistic regression with least absolute shrinkage and selection operator to develop a prognostic model for 5-year risk of dementia or death.

RESULTS: Cohort members (N = 113,779) had a mean ± SD age of 68 ± 10 years; 6% were female, and 20% were non-White or Hispanic. The key predictors of dementia or death included older age; male sex; number of inpatient visits; and comorbidities such as Parkinson disease, diabetes, weight loss, epilepsy, substance use disorder, and psychosis. The c-statistics were 0.756 (95% CI 0.751-0.761) for dementia and 0.783 (0.779-0.786) for death. Among those in the lowest predicted decile of dementia risk, 3% developed dementia within 5 years, compared with 43% of those in the highest predicted decile of risk. Similarly, the proportion of participants who died without dementia was 4% among those in the lowest predicted decile of risk compared with 64% in the highest predicted decile of risk.

DISCUSSION: A single prognostic model that includes demographics, comorbidities, and utilization variables can predict risk of dementia or death in older veterans who have experienced TBI with good accuracy. Additional studies are needed to determine how this information might be best used to support better care.

PMID:40789104 | DOI:10.1212/WNL.0000000000213983

Neurology. 2025 Sep 9;105(5):e213979. doi: 10.1212/WNL.0000000000213979. Epub 2025 Aug 11.

ABSTRACT

BACKGROUND AND OBJECTIVES: Food deserts (FDs) are low-income areas with poor access to healthy foods. FD residents have higher rates of several cardiovascular risk factors, but the link between FDs and stroke has not been well studied. We evaluated whether FD residence was associated with incident ischemic stroke within the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) and whether this association was due to low income, poor food access, or both.

METHODS: All hospitalized stroke cases in the GCNK region were ascertained during calendar year 2015 using ICD-9 and ICD-10 codes for screening and confirmed by physician review. Patient home addresses were geocoded using Decentralized Geomarker Assessment for Multi-Site Studies. FD locations were obtained from the US Department of Agriculture Food Access Research Atlas, defined as census tracts with both poor food access and low income according to established definitions based on proximity to healthy food sources as well as area poverty rates and median household income. Population estimates were obtained from the 2015 5-year American Community Survey. Poisson regression models were used to calculate census tract-level incidence rates by FD status, as well as by food access and income categories, adjusting for age, sex, race, and income-by-access interaction.

RESULTS: A total of 1,802 first-ever ischemic stroke incidents occurred in the region during the study period. Stroke patients had a mean age of 69.7 years, and 53% were female. In unadjusted models, FD residence (vs non-FD) was associated with higher stroke incidence (incidence rate ratio [IRR] 1.23; 95% CI 1.06-1.42; p < 0.01). After adjustment for age, sex, and race, this relationship was attenuated and no longer statistically significant (IRR 1.11; 95% CI 0.96-1.30; p = 0.17). In a model where FD status was replaced by area income and food access (i.e., the 2 components of the FD definition), low income was associated with greater stroke incidence after full adjustment (IRR 1.21; 95% CI 1.05-1.39; p = 0.01) while poor food access was not (IRR 0.91; 95% CI 0.81-1.01; p = 0.08).

DISCUSSION: FD residents are at increased stroke risk, and this is primarily due to low area income rather than poor food access. Alternative measures of the food environment may help elucidate the links between income, dietary patterns, and stroke risk.

PMID:40789103 | DOI:10.1212/WNL.0000000000213979

Isotopes Environ Health Stud. 2025 Aug 11:1-23. doi: 10.1080/10256016.2025.2543001. Online ahead of print.

ABSTRACT

This pioneering study assesses the radiological risk of naturally occurring radionuclides in soil around the Bheramara 410 MW Combined Cycle Power Plant (natural gas and high-speed diesel) in Kushtia, Bangladesh. Thirty soil samples were collected at radial distances of 50 m, 500 m, 1000 m, and 3000 m from the plant, these distances were strategically selected to represent immediate proximity (50 m), near-field (500 m), mid-range (1000 m), and far-field (3000 m) zones, enabling a gradient analysis of potential radiological impact. Using high-purity germanium (HPGe) gamma-ray spectrometry, the activity concentrations of ²²⁶Ra, ²³²Th, and ⁴⁰K were found to range from 20 ± 2 to 28 ± 3 Bq/kg, 25 ± 2 to 41 ± 4 Bq/kg, and 310 ± 21 to 440 ± 34 Bq/kg, respectively. While ²²⁶Ra concentrations were below the global average (30 Bq/kg), some measured values of ²³²Th exceeded the global average of 35 Bq/kg, and ⁴⁰K concentrations in certain samples were higher than the global average of 400 Bq/kg. No detectable ¹³⁷Cs was observed, confirming no artificial contamination. Radiological hazard indices such as radium equivalent activity (mean: 100.60 Bq/kg), outdoor absorbed dose rate (mean: 48.56 nGy/h), outdoor annual effective dose (mean: 0.06 mSv/year), external hazard index (mean: 0.27), gamma representative level index (mean: 0.74), and excess lifetime cancer risk (mean: 0.22 × 10^-3) were all within recommended safety limits. Various statistical analyses, including descriptive statistics, Pearson correlation, principal component analysis (PCA), and hierarchical cluster analysis (HCA), were performed and these revealed that ²²⁶Ra and ²³²Th were the main contributors to radiological risk, while ⁴⁰K showed weaker associations. The findings suggest that the soil is safe for agricultural and construction use, but routine monitoring is recommended to ensure environmental protection. This study provides essential baseline data and analytical insight into radiological risk management in power generation industrial regions of Bangladesh.

PMID:40789079 | DOI:10.1080/10256016.2025.2543001

Adv Sci (Weinh). 2025 Aug 11:e04562. doi: 10.1002/advs.202504562. Online ahead of print.

ABSTRACT

Alternative polyadenylation of pre-mRNA generates mRNAs with alternative 3′ ends, thereby increasing the complexity of the transcriptome and proteome. This process is carried out by pre-mRNA 3′ end processing complexes, with the specificity and site selection of polyadenylation primarily defined by the interaction between these complexes and conserved pre-mRNA cis-elements. However, the cis-element recognized by the polyadenylation CFII complex and the downstream cis-element of the poly(A) site remain unknown. Here, FPA, a conserved Spen family RNA-binding protein, is identified to physically interacts with the CFII complex in Arabidopsis. FPA specifically binds to a GA-rich cis-element downstream of the proximal poly(A) site, which is required for the CFII complex to promote proximal poly(A) site usage and prevent 3′ extension. Thus, the CFII complex recognizes the downstream cis-element of the poly(A) site through its interaction with FPA, highlighting the role of RNA-binding proteins as accessory factors in alternative polyadenylation.

PMID:40789077 | DOI:10.1002/advs.202504562