Nevin Manimala

Curr Eye Res. 2025 Jul 14:1-9. doi: 10.1080/02713683.2025.2531524. Online ahead of print.

ABSTRACT

PURPOSE: Determination of the amplitude of accommodation (AoA) is a clinical technique used in ophthalmology and optometry to assess the eye’s ability to focus on near objects. This study compares the reliability of a novel motorized push-up variant with conventional manual push-up and push-down methods for the determination of AoA in 26 emmetropes.

METHODS: The motorized push-up method reduces limitations of the manual methods, such as differences due to varying examiner abilities, ruler placement (forehead, zygomatic bone, spectacle plane), and inconsistent target movement speeds. This is achieved by providing a participant-controlled, constant target movement of 2 cm/s, with the medial zone of the zygomatic bone as the reference point for ruler placement. Additionally, digital image-based and traditional ruler-based AoA measurements were compared. The participants’ impressions of the three methods were assessed based on ease of use, confidence in measurement reliability, and comfort of experience, using a questionnaire.

RESULTS: The comparison of the AoA across the methods revealed no statistically significant differences. However, the concordance correlation coefficient was highest between the motorized and manual push-up method (ρ_c = 0.72). All methods showed good test-retest reliability with the highest ICC found for the motorized push-up method (0.83), which also had the narrowest limits of agreement interval for accommodative demand (3.22 cm). Beyond digital and ruler-based measurements showed underestimation by both rulers, with a mean bias of 0.3 cm for the motorized ruler compared to about 2.0 cm for the conventional ruler. The questionnaire responses suggest that the motorized version outperforms the manual versions being 5 times more likely to score higher for ease of use and 6 times more likely for confidence in measurement reliability.

CONCLUSION: These findings demonstrate that the motorized push-up method effectively measures the AoA, reduces interfering factors, and provides higher reliability without compromising precision, making it a valuable alternative to conventional methods.

PMID:40654173 | DOI:10.1080/02713683.2025.2531524

Acta Crystallogr D Struct Biol. 2025 Aug 1. doi: 10.1107/S2059798325005923. Online ahead of print.

ABSTRACT

Atomic coordinate models are important for the interpretation of 3D maps produced with cryoEM and cryoET (3D electron microscopy; 3DEM). In addition to visual inspection of such maps and models, quantitative metrics can inform about the reliability of the atomic coordinates, in particular how well the model is supported by the experimentally determined 3DEM map. A recently introduced metric, Q-score, was shown to correlate well with the reported resolution of the map for well fitted models. Here, we present new statistical analyses of Q-score based on its application to ∼10 000 maps and models archived in the EMDB (Electron Microscopy Data Bank) and PDB (Protein Data Bank). Further, we introduce two new metrics based on Q-score to represent each map and model relative to all entries in the EMDB and those with similar resolution. We explore through illustrative examples of proteins, nucleic acids and small molecules how Q-scores can indicate whether the atomic coordinates are well fitted to 3DEM maps and also whether some parts of a map may be poorly resolved due to factors such as molecular flexibility, radiation damage and/or conformational heterogeneity. These examples and statistical analyses provide a basis for how Q-scores can be interpreted effectively in order to evaluate 3DEM maps and atomic coordinate models prior to publication and archiving.

PMID:40654171 | DOI:10.1107/S2059798325005923

J Clin Nurs. 2025 Jul 14. doi: 10.1111/jocn.70034. Online ahead of print.

ABSTRACT

AIM: To examine the impact of critical care nurses’ delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information-motivation-behavioural (IMB) skills model from a behavioural perspective.

DESIGN: Cross-sectional study.

METHODS: A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson’s correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.

RESULTS: The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.

CONCLUSION: Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses’ delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals’ sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Critical care managers should value nurses’ delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses’ delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.

REPORTING METHOD: The STROBE checklist was used as a guideline.

PATIENT OR PUBLIC CONTRIBUTION: Nurses completed questionnaires.

TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216.

PMID:40654168 | DOI:10.1111/jocn.70034

Lab Med. 2025 Jul 12:lmaf038. doi: 10.1093/labmed/lmaf038. Online ahead of print.

ABSTRACT

INTRODUCTION: Artificial intelligence is increasingly used in medical education and testing. ChatGPT, developed by OpenAI, has shown mixed results on various medical exams, but its performance in medical laboratory genetics remains unknown.

METHODS: This study assessed ChatGPT-3.5 using 456 publicly available questions from the Polish national specialist exam in medical laboratory genetics. Questions were categorized by topic and complexity (simple vs complex) and submitted to ChatGPT 3 times. Accuracy and consistency were statistically evaluated.

RESULTS: ChatGPT correctly answered 59% of the 456 exam questions, which was statistically significant (P < .001). Accuracy differed by category: 71% for calculation-based questions, approximately 60% for genetic methods and genetic alterations, and only 37% for clinical case-based questions. Question complexity also affected performance: Simple questions had 63% accuracy, while complex questions yielded 43% (P = .001). No statistically significant differences were found across 3 repeated sessions, with performance remaining stable over time (P = .43).

DISCUSSION: ChatGPT-3.5 demonstrated moderate accuracy and stable performance on a specialist exam in medical genetics. Although it may support education in this field, the tool’s limitations in complex, domain-specific reasoning suggest the need for further development before broader implementation.

PMID:40654165 | DOI:10.1093/labmed/lmaf038

Personal Ment Health. 2025 Aug;19(3):e70032. doi: 10.1002/pmh.70032.

ABSTRACT

The LPFS-BF 2.0 (Level of Personality Functioning-Brief Form 2.0) is a brief self-report instrument that was developed in order to gain a quick first impression of personality dysfunction and was designed to align with the Level of Personality Scale as outlined in the DSM-5 Alternative Model for Personality Disorders (AMPD). In the current study, we used a factor analytic framework to evaluate the longitudinal measurement invariance of the Norwegian version of the LPFS-BF 2.0 in a sample of 1030 patients referred for personality disorder treatment with the R package lavaan. Additionally, we estimated item response theory (IRT) parameters for the 12 items, as well as local reliability, in order to facilitate comparisons with other studies. We found support for partial measurement invariance. Three items showed different thresholds across time points. However, these differences were minor and did not have a substantial impact on the estimated factor scores. The discrimination parameters were lower than could be expected for an instrument used in a clinical setting. Taking these findings together, we conclude that although the LPFS-BF 2.0 seems to measure the same latent trait across time, the items do not discriminate well between patients with high and low scores in a Norwegian population of adults seeking treatment for PD. Important next steps would be to estimate IRT parameters for comparable patient samples from other countries to assess the generalizability of our findings and to compare the LPFS-BF 2.0 scores to scores obtained through a clinical interview that aligns with the AMPD.

PMID:40654158 | DOI:10.1002/pmh.70032

J Clin Nurs. 2025 Jul 14. doi: 10.1111/jocn.70035. Online ahead of print.

ABSTRACT

AIM: To determine the prevalence of MARSI associated with peripherally inserted central venous catheters (PICCs) in oncology and haematology patients, analyse the type of injury and identify risk factors.

METHODOLOGY: A prospective descriptive study was conducted from 9 June 2021 to 8 February 2022. The study population was oncology and haematology patients with a PICC. The variables to be studied included the presence of MARSI in relation to PICC maintenance, injury type, time to onset, mean healing time, and type of treatment received. A descriptive analysis of the entire sample was performed. Chi-square and Student’s t-test or Mann-Whitney U-tests were used to identify risk factors, depending on the nature of the variables.

RESULTS: The sample studied was 342 PICCs inserted in 309 patients, 49% (n = 169) women, and the mean overall age was 62.12 years (SD: 12.33). Seventy-six per cent were oncology and 24% haematology patients. The prevalence of MARSI was 32% (n = 111). The most common type of injury was erythema in 39% (n = 42). The mean duration of the lesion was 20.90 days (SD: 31.44). Alkylating agents, among others, were identified as a risk factor.

CONCLUSIONS: The results indicate a high prevalence of MARSI. In agreement with the literature, mechanical injuries are the most frequent, and some antineoplastic treatments are a risk factor. This study may help to identify areas for improvement and design strategies for the prevention and treatment of MARSI.

RELEVANCE TO CLINICAL PRACTICE: This study has implications for clinical practice, as it helps to identify areas for improvement and the most relevant clinical practice guideline recommendations to avoid this adverse event.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:40654153 | DOI:10.1111/jocn.70035

Adicciones. 2025 May 30;37(2):101-112. doi: 10.20882/adicciones.1995.

ABSTRACT

Some smokers use electronic cigarettes (e-cigs) as an aid to quit smoking or as a harm reduction strategy. However, these smokers may end up using e-cigs and conventional cigarettes, becoming dual users. The main aim of this study was to assess the reasons why dual users use e-cigs. In addition, as a secondary objective, the conflicts of interest and funding of the included studies were analyzed.

METHODS: A search was conducted in PubMed, EMBASE, Web of Science and PsychInfo databases until November 2023. Cross-sectional studies were selected that included dual users of conventional tobacco and e-cigs and analyzed the reasons for e-cig use. The Newcastle Ottawa Quality Assessment Scale was applied to assess the quality of the included studies.

RESULTS: Fourteen studies were included. One assessed reasons for initiation, 12 for maintenance of use, and one assessed both separately. Reduction in the number of cigarettes smoked and the perception that e-cigs are less harmful were the main reasons for initiation and maintenance of use. Among the 10 studies that presented a conflict of interest statement, three had conflicts with the pharmaceutical industry. Information on funding was included in 12 studies, of which nine received public funding and one received funding from the pharmaceutical industry.

CONCLUSIONS: Identifying the reasons for e-cig use among dual users of e-cigs and conventional tobacco is fundamental for the design of smoking cessation programs and programs aimed at increasing the population’s knowledge of new forms of consumption.

PMID:40654145 | DOI:10.20882/adicciones.1995

Glob Health Action. 2025 Dec;18(1):2513719. doi: 10.1080/16549716.2025.2513719. Epub 2025 Jul 14.

ABSTRACT

Rising temperatures in Africa present an increasing threat to agricultural productivity and public health, particularly among subsistence farming communities reliant on rain-fed agriculture. Heat exposure can impair farmers’ work capacity, disrupt harvests, and heighten health risks, especially for young children vulnerable to undernutrition. The Heat to Harvest (H2H) study investigates how environmental heat exposure influences farmers’ physiological and behavioral responses, and how these in turn affect harvest yields and child nutrition. It also examines differences in labor performance and recovery between households with and without cool roof coatings, although this intervention is not the central focus. H2H is designed as a prospective cohort study nested within two Health and Demographic Surveillance Systems (HDSS) in Nouna, Burkina Faso, and Siaya, Kenya. The study integrates environmental monitoring (temperature and humidity sensors used to compute Wet Bulb Globe Temperature), biometric data (via wearables tracking heart rate, temperature, physical activity, energy expenditure, and sleep), and GPS tracking (capturing spatial mobility and labor duration). The study is embedded within a larger cluster-randomized controlled trial, facilitating comparative analysis under varying thermal conditions. Findings will provide evidence-based insights into how climate-related heat stress affects health and agricultural outcomes, supporting the development of targeted adaptation strategies to enhance resilience, health, and food security in vulnerable farming communities.

PMID:40654138 | DOI:10.1080/16549716.2025.2513719

Arthritis Care Res (Hoboken). 2025 Jul 14. doi: 10.1002/acr.25609. Online ahead of print.

ABSTRACT

OBJECTIVE: We evaluated trends in dermato-polymyositis (DPM) mortality relative to all-cause mortality in the United States, 1999-2022.

METHODS: We used the Center for Disease Control and Prevention’s databases (Multiple Causes of Death for 1999-2020 and Provisional Mortality Statistics for 2021 and 2022) to obtain death counts for DPM and non-DPM (all causes other than DPM). We calculated age-standardized mortality rates (ASMR) for both groups and computed the ratio of DPM-ASMR to non-DPM-ASMR for each of the 24 years. We performed joinpoint regression analysis to estimate annual percent change (APC) in DPM and non-DPM ASMRs and in the DPM-ASMR:non-DPM-ASMR ratios, overall and by sex, age, and race/ethnicity.

RESULTS: There were 12,882 DPM and 63,549,485 non-DPM deaths during 1999-2022. Mortality decreased at a higher APC (-3.8% [95% CI, -4.3%, -3.4%]) for DPM than non-DPM (-1.2% [95% CI, -1.5%, -0.9%]) until the start of the COVID-19 pandemic, when it increased for both at similar APCs. Consequently, the ratios of DPM-ASMRs to non-DPM-ASMRs decreased over these 24 years in all subgroups. The DPM-ASMR to non-DPM-ASMR ratios were higher in females than males, and in younger individuals (≤64 years) than those ≥65 years. The odds of premature death were higher for DPM than non-DPM. Non-Hispanic Black, Hispanic, and non-Hispanic others had higher DPM-ASMR to non-DPM-ASMR ratios than White individuals.

CONCLUSION: DPM mortality decreased at a higher rate than all-cause mortality until the pandemic, when it proportionately increased for both DPM and all causes. Females, younger, Black, Hispanic, and non-Hispanic other individuals had higher DPM mortality relative to all-cause mortality. Findings highlight the need for improved screening, earlier intervention, and targeted efforts to address racial/ethnic disparities in DPM outcomes.

PMID:40654129 | DOI:10.1002/acr.25609

Phytochem Anal. 2025 Jul 14. doi: 10.1002/pca.70011. Online ahead of print.

ABSTRACT

INTRODUCTION: Galls, which are abnormal or protruding tissues, form when insects bite plant cells and serve as evidence for understanding plant-insect interactions.

OBJECTIVES: This study is aimed at understanding the interactions between Chrysanthemum species and insects at the metabolomic level and to reveal the metabolic changes induced by insect galls.

METHODOLOGY: This study employed liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS), along with multivariate statistics and pathway enrichment, for metabolomic profiling of Chrysanthemum glabriusculum, including gall-infected and gall-free leaves, and reported the gall phenomenon in Chrysanthemum species for the first time.

RESULTS: LC-MS metabolomics analysis identified 105 marker metabolites, with 61 upregulated and 42 downregulated. Organic acids were the most abundant (20.00%), followed by carbohydrates (16.19%) and flavonoids (14.29%). KEGG analysis revealed significant pathway enrichment in flavone and flavonol biosynthesis, the TCA cycle, and galactose metabolism (p < 0.05). GC-MS metabolomics analysis revealed 27 volatile secondary metabolites, predominantly terpenoids (16 types), followed mainly by alcohol (4 types) and ketone compounds (three types). VIP > 1 analysis revealed 13 differentially signature metabolites; gall tissue (CgCa) presented elevated levels of β-phellandrene, camphene, and 1,8-Cineole, whereas γ-Muurolene, α-Farnesene, and Copaene were downregulated in CgCa.

CONCLUSIONS: During gall induction, C. glabriusculum plays an important role in energy metabolism through the regulation of key metabolic pathways, such as galactose metabolism and the TCA cycle, and their products; moreover, by regulating the biosynthesis of flavonoids and flavonols and the corresponding accumulation of secondary metabolites (terpenoids, ketones, and alcohols), it defends against insect-induced galls.

PMID:40654123 | DOI:10.1002/pca.70011