Nevin Manimala

Nurse Educ Today. 2025 Aug 28;155:106857. doi: 10.1016/j.nedt.2025.106857. Online ahead of print.

ABSTRACT

BACKGROUND: Developing interprofessional competencies at the pre-registration level is essential for preparing a collaborative practice-ready workforce committed to patient-centered care and safety.

AIM: (1) To evaluate the impact of a Blended Learning Approach with Simulation-based TeamSTEPPS® (BLAST) training on nursing and medical students’ attitudes, knowledge, and perceived confidence in interprofessional collaboration, and (2) to explore the learning experiences of students and teaching experiences of simulation facilitators.

DESIGN: Mixed-methods design using a one-group pretest-posttest design and focus group discussions.

SETTING: A public tertiary university in Singapore.

METHODS: Final year nursing and medical students participated in the BLAST training, which delivered the TeamSTEPPS® training using multi-user virtual reality simulation followed by high-fidelity simulation. Pre- and post-tests assessed students’ understanding of TeamSTEPPS® key concepts and tools, as well as their attitudes and perceived confidence in interprofessional teamwork. Nine focus group discussions were conducted with students and simulation facilitators. Quantitative and qualitative data were triangulated.

RESULTS: Students demonstrated statistically significant improvements in their understanding of TeamSTEPPS® key concepts, overall attitudes towards interprofessional teamwork, and perceived value of interprofessional training. The virtual reality simulation was reported to improve students’ confidence in participating the high-fidelity simulation. Three themes emerged from the focus group discussions: (1) synergy of interprofessional learning, (2) blended simulation as a learning scaffold, and (3) operationalizing blended simulation. The triangulated data revealed that the integration of virtual reality simulation followed by in-person simulation was a promising pedagogical approach for interprofessional training.

CONCLUSION: This study supports the use of a blended simulation-based learning approach for interprofessional team training, highlighting the benefits of scaffolded learning in enhancing knowledge, collaboration, and communication skills among nursing and medical students. The findings point to the need for innovative approaches to enable sustainable and scalable interprofessional team training.

PMID:40902360 | DOI:10.1016/j.nedt.2025.106857

Curr Opin Neurobiol. 2025 Sep 2;94:103107. doi: 10.1016/j.conb.2025.103107. Online ahead of print.

ABSTRACT

In many brain areas, neurons exhibit continuous changes in their tuning properties over days, even when supporting stable percepts and behaviors-a phenomenon termed representational drift. How do neuronal circuits maintain stable function when their constituent elements are in constant flux? Here, we review recent theoretical and experimental work on interconnected levels, ranging from perpetual changes in synapses driving drifts in tuning of individual neurons to emergent stability at the population level, preserving similarities of activity patterns associated to specific percepts or behaviors. We propose that statistical learning, beyond its well-established roles during development and adaptation to new contexts, is also essential under steady behavioral and environmental conditions to safeguard the stability of representational similarities. We discuss implications for learning, memory, and forgetting. This framework reconciles the apparent paradox between unstable neural activity and stable perception, suggesting that representations are maintained through dynamic processes rather than static neural codes.

PMID:40902357 | DOI:10.1016/j.conb.2025.103107

Poult Sci. 2025 Aug 23;104(11):105719. doi: 10.1016/j.psj.2025.105719. Online ahead of print.

ABSTRACT

To meet the increasing demand for eggs, while limiting the environmental impact, an increased efficiency of laying hen production is required. Feed efficiency (FE) plays a major role in this. In broilers, relationships between nutrient digestibility and FE have been observed, suggesting that information on digestibility coefficients (DCs) has potential to aid in prediction of FE. This study examines whether DCs, as determined by chemical analysis of laying hen manure, can serve as a predictor of FE in laying hens. In total, 100 laying hens from two lines differing in FE (line A and B) were studied. The objective of this study was two-fold: to investigate 1) the variation in DCs between and within the two lines, and 2) the use of DCs for prediction of FE in laying hens. Differences in performance and DCs were observed between the two laying hen lines. Line A hens showed a higher daily feed consumption and daily body weight, as well as lower egg mass, daily manure weights and laying percentages. Furthermore, all DCs were higher in line A than in line B. For line A, phenotypic correlations between DCs and feed conversion ratio (FCR) were moderate and ranged from 0.31 (DC for fat hydrochloric) to 0.60 (DC for organic matter). Correlations between residual feed consumption (RFC) and DCs ranged from 0.32 (DC for fat hydrochloric) to 0.79 (DC for dry matter). For line B, correlations between FCR and the DCs were not statistically significant, while the correlations between RFC and DCs ranged from 0.31 (DC for fat hydrochloric) to 0.43 (DC for organic matter). The contribution of different DCs in prediction models for FE differed between the two lines, making across-line FE prediction challenging in laying hens. Overall, the data on DCs collected in this study contribute to an improved understanding of differences in digestibility between laying hen lines and show potential for FE prediction.

PMID:40902343 | DOI:10.1016/j.psj.2025.105719

Vaccine. 2025 Sep 2;63:127687. doi: 10.1016/j.vaccine.2025.127687. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to estimate SARS-CoV-2 vaccine effectiveness (VE) against medically attended SARS-CoV-2 infection in Hong Kong.

METHODS: We conducted a test-negative design study in individuals aged 5-64 years who presented with recent-onset (≤3 days) acute respiratory illness from April 2023 through to August 2024. Vaccination was defined as receipt of SARS-CoV-2 vaccine within 6 months of medical presentation, and for a sensitivity analysis, within 12 months of medical presentation. VE against laboratory-confirmed SARS-CoV-2 infection was estimated separately for 5-17-year-olds and 18-64-year-olds by conditional logistic regression adjusted for potential confounders.

RESULTS: Within the age groups, there was no statistically significant difference in vaccination (within 6 months of medical presentation) proportions between cases and controls across strata of the assessed individual sociodemographic and health-related characteristics. A moderate VE of 64 % (95 % confidence interval, CI: 9-83 %) and 54 % (95 % CI: -39 to 77 %) was estimated in 5-17-year-olds and 18-64-year-olds, respectively. However, a higher VE of 85 % (95 % CI: 32-97 %) and a moderate VE of 59 % (95 % CI: 2-83 %) were estimated in 5-17-year-olds for mRNA and inactivated vaccines, respectively, although non-statistically significantly different (p = 0.33) whereas a lower VE of 29 % (95 % CI: -81 to 73 %) and a higher VE of 70 % (95 % CI: -5 to 92 %) were estimated in 18-64-year-olds for mRNA and inactivated vaccines, respectively, which were not statistically significantly different from each other (p = 0.38). VE estimates were higher for those who had had a previous SARS-CoV-2 infection compared with those who had not. VE was also higher in 5-17-year-olds who had self-tested for SARS-CoV-2 infection before medical presentation and lower in those who had not, whereas the opposite was observed in 18-64-year-olds.

CONCLUSIONS: SARS-CoV-2 vaccines provided substantial protection against medically attended SARS-CoV-2 infection in both children and adults in Hong Kong.

PMID:40902334 | DOI:10.1016/j.vaccine.2025.127687

J Infect Public Health. 2025 Sep 1;18(11):102948. doi: 10.1016/j.jiph.2025.102948. Online ahead of print.

ABSTRACT

BACKGROUND: Bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients with hematological malignancies (HMs).

METHODS: This 14-year retrospective study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from 2007 to 2021. It examined the epidemiological profile, microbial spectrum, resistance patterns, and outcomes of BSIs in HM patients. Microbial identification was based on aerobic and anaerobic blood cultures; PCR testing was used requested as needed. Statistical analysis was performed in Excel, including one-way ANOVA, Chi-square, and linear regression.

RESULTS: Among 2112 HM patients, 296 (14 %) experienced at least one BSI episode. Incidence peaked in 2014, 2016, and 2017, with a subsequent decline possibly reflecting improved infection control. Bacterial infections comprised 90 % of cases (n = 1341), the highest was Gram-negative organisms (n = 745) such as E. coli (n = 86) and Klebsiella pneumoniae (n = 77). Gram-positive pathogens (n = 596) included coagulase-negative Staphylococci (n = 319) and Staphylococcus aureus (n = 75). Fungal infections accounted for 4 % (n = 61), primarily Candida albicans. Resistance was high (21.1 %), particularly in Enterococcus (48.9 %), Acinetobacter (45.8 %), E. coli ESBL (40.3 %), and Klebsiella pneumoniae CRE/ESBL (45 %, 32.5 %). The overall mortality was 85 %, significantly higher for resistant Klebsiella pneumoniae (100 % vs. 88.7 %, p = 0.008) and notably elevated for E. coli ESBL (94.2 % vs. 83.1 %, p = 0.063). Adults had the highest incidence. Combined aerobic (69 %) and anaerobic (31 %) cultures improved diagnostic yield, especially in polymicrobial infections.

PMID:40902323 | DOI:10.1016/j.jiph.2025.102948

J Infect Public Health. 2025 Aug 26;18(11):102939. doi: 10.1016/j.jiph.2025.102939. Online ahead of print.

ABSTRACT

BACKGROUND: Taiwan experienced a major dengue outbreak in 2023 following the relaxation of COVID-19 border controls. The contributing factors remained unclear. This study investigated potential virological, immunological, and clinical drivers.

METHODS: We retrospectively analyzed laboratory-confirmed dengue virus (DENV) infections at a tertiary care hospital in southern Taiwan. Serotypes were identified by qRT-PCR. Viral origins were assessed through phylogenetic and envelope (E) gene amino acid analyses. Clinical features of DENV-1 and DENV-2 cases were compared. Neutralization and antibody-dependent enhancement (ADE) were evaluated using PRNT and ADE assays.

RESULTS: DENV-1 and DENV-2 were identified as the predominant circulating serotypes. Clinical analysis revealed that DENV-2 infection was significantly associated with older age, diabetes mellitus, hypertension, and elevated hematocrit levels (p < 0.05), and these associations remained statistically significant in multivariate analysis. Phylogenetic analysis showed that DENV-1 isolates belonged to genotypes I and IV, while DENV-2 strains were of the cosmopolitan genotype. These viruses clustered closely with strains from Southeast Asia. Amino acid analysis indicated that DENV-1 strains exhibited 2-10 substitutions relative to 2014 isolates, while DENV-2 strains closely matched those from 2015. Sera from the 2014-2015 outbreaks demonstrated potent homotypic but limited heterotypic neutralization. ADE was observed in heterotypic infection contexts.

CONCLUSIONS: The 2023 dengue outbreak in Taiwan was driven by co-circulation of DENV-1 and DENV-2, limited heterotypic immunity, and ADE. These findings highlight the importance of integrated virological surveillance, genotype monitoring, and immunological assessment to inform dengue control strategies in non-endemic regions experiencing imported viral threats.

PMID:40902322 | DOI:10.1016/j.jiph.2025.102939

Comput Med Imaging Graph. 2025 Sep 1;125:102642. doi: 10.1016/j.compmedimag.2025.102642. Online ahead of print.

ABSTRACT

An increasing number of publicly available datasets have facilitated the exploration of building universal medical segmentation models. Existing approaches address partially labeled problem of each dataset by harmonizing labels across datasets and independently focusing on the labeled foreground regions. However, significant challenges persist, particularly in the form of cross-site domain shifts and the limited utilization of partially labeled datasets. In this paper, we propose a GAMOS (Generic Abdominal Multi-Organ Segmentation) framework. Specifically, GAMOS integrates a self-guidance strategy to adopt diffusion models for partial labeling issue, while employing a self-distillation mechanism to effectively leverage unlabeled data. A sparse semantic memory is introduced to mitigate domain shifts by ensuring consistent representations in the latent space. To further enhance performance, we design a sparse similarity loss to align multi-view memory representations and enhance the discriminability and compactness of the memory vectors. Extensive experiments on real-world medical datasets demonstrate the superiority and generalization ability of GAMOS. It achieves a mean Dice Similarity Coefficient (DSC) of 91.33% and a mean 95th percentile Hausdorff Distance (HD95) of 1.83 on labeled foreground regions. For unlabeled foreground regions, GAMOS obtains a mean DSC of 86.88% and a mean HD95 of 3.85, outperforming existing state-of-the-art methods.

PMID:40902292 | DOI:10.1016/j.compmedimag.2025.102642

Placenta. 2025 Jul 23;170:87-96. doi: 10.1016/j.placenta.2025.07.084. Online ahead of print.

ABSTRACT

INTRODUCTION: Quantification of placental histopathological structures is challenging due to a limited number of perinatal pathologists, constrained resources, and subjective assessments prone to variability. Objective standardization of placental structure is crucial for easing the burden on pathologists, gaining deeper insights into placental growth and adaptation, and ultimately improving maternal and fetal health outcomes.

METHODS: Leveraging advancements in deep-learning segmentation, we developed an automated approach to detect over 9 million placenta chorionic villi from 1531 term placental whole slide images from the New Hampshire Birth Cohort Study. Using unsupervised clustering, we successfully identified biologically relevant villi subtypes that align with previously reported classifications – terminal, mature intermediate, and immature intermediate – demonstrating consistent size distributions and comparable abundance. We additionally defined tertile-based combinations of villi area and circularity to characterize villous geometry. This study applies these cutting-edge AI methods to quantify villi features and examine their association with maternal and infant characteristics, including gestational age at delivery, maternal age, and infant sex.

RESULTS: Increasing gestational age at delivery was statistically significantly associated (p = 0.003) with an increase in the proportion of mature intermediate villi and a decrease in the proportion of the smallest, most circular villi (p < 0.001). Maternal age and infant sex were not statistically significantly associated with measures of villous geometry.

DISCUSSION: This work presents a workflow that objectively standardizes chorionic villi subtypes and geometry to enhance understanding of placental structure and function, while providing insights into the efficiency, growth, and the architecture of term placentas which can be used to inform future clinical care.

PMID:40902262 | DOI:10.1016/j.placenta.2025.07.084

Environ Int. 2025 Aug 28;203:109762. doi: 10.1016/j.envint.2025.109762. Online ahead of print.

ABSTRACT

BACKGROUND: Testicular germ cell cancer (TGCC) originates during fetal life. Fetal exposure to environmental chemicals may contribute to its development, but epidemiological data are lacking. We investigated per- and polyfluoroalkyl substances (PFAS), which can act as endocrine disruptors during fetal development, and TGCC risk in adulthood.

METHODS: We conducted a nested case-control study of 549 mother-male offspring pairs (103 TGCC cases, 446 matched controls). The source population included over 100,000 pregnant women with biobanked serum samples collected during 1985-1994, a period before PFAS restrictions. Male offspring were followed for up to 38 years, and TGCC cases were identified from the Danish Cancer Registry based on histological confirmation. Eight PFAS were quantified in maternal serum using LC-MS/MS. Associations between individual PFAS and their mixtures with TGCC risk were assessed through Cox regression and quantile g-computation models.

RESULTS: Associations between individual PFAS and TGCC risk were modest and not statistically significant. Hazard ratios (HRs) for perfluoroalkyl sulfonic acids (PFOS, PFHxS, PFHpS) suggested higher TGCC risks per quartile increase in concentrations, but lower risks for perfluoroalkyl carboxylic acids (PFOA, PFNA, PFDA, PFHpA, PFUnDA). Mixture analyses supported this pattern, with higher TGCC risk for the joint effect of sulfonic acids (HR 1.13, 95 % CI: 0.89; 1.44). Stratified analyses by histological subtype showed higher risk for seminomas than for nonseminomas across all PFAS.

CONCLUSIONS: We found limited evidence of an association between fetal PFAS exposure and TGCC risk. Indications of a potential adverse effect of perfluoroalkyl sulfonic acids, particularly for seminomas, merit further research.

PMID:40902259 | DOI:10.1016/j.envint.2025.109762

J Behav Ther Exp Psychiatry. 2025 Aug 31;90:102069. doi: 10.1016/j.jbtep.2025.102069. Online ahead of print.

ABSTRACT

This study explored the relationships between dissociative experiences, childhood trauma, maladaptive schemas, schema modes, and schema coping in a nonclinical sample. Three theoretical models were tested: (1) dissociative experiences resulting from schema mode activation, (2) dissociative experiences as an innate trait shaping schema coping, and (3) dissociative experiences arising from childhood trauma that influence coping strategies. Data from 401 Dutch psychology students were analyzed using path analyses to compare model fit. While all models showed good fit, Model 2 emerged as the best based on AIC and BIC values. This model linked dissociative experiences to avoidance and surrender coping styles and specific schema modes, such as the punitive parent and detached self-soother. Findings suggest dissociative experiences shape responses to schema-related stress through disengagement or immersion. Future research in clinical populations is recommended to further explore these dynamics and their therapeutic relevance.

PMID:40902253 | DOI:10.1016/j.jbtep.2025.102069