Nevin Manimala

EuroIntervention. 2025 Aug 30:EIJ-D-25-00826. doi: 10.4244/EIJ-D-25-00826. Online ahead of print.

ABSTRACT

BACKGROUND: Current guidelines recommend beta blockers after myocardial infarction (MI) regardless of left ventricular ejection fraction (LVEF), aiming to reduce reinfarction and ventricular arrhythmias. However, recent trials have challenged this practice in patients without reduced LVEF. Whether beta blocker withdrawal in these patients increases short-term or recurrent ischaemic events remains uncertain.

AIMS: We aimed to evaluate the short-term ischaemic safety of beta blocker withholding or withdrawal at hospital discharge in patients with MI and LVEF >40% and to determine the effect of beta blocker therapy on a broad composite ischaemic endpoint.

METHODS: This is a post hoc analysis of the REBOOT trial, in which patients with MI and LVEF >40% were randomised to beta blocker therapy or no beta blocker at discharge. The incidence of short-term (3-month) and recurrent ischaemic events (a composite of cardiac death, reinfarction, sustained ventricular tachycardia/fibrillation, resuscitated cardiac arrest, or unplanned revascularisation) was assessed overall and according to prior beta blocker use.

RESULTS: From the 8,438 patients in the intention-to-treat population of the trial, information regarding beta blocker history was available for 8,401. Of these, 12.1% were on chronic beta blocker therapy before MI. Overall, withholding or withdrawing beta blockers was not associated with increased short-term ischaemic risk (hazard ratio [HR] 1.13, 95% confidence interval [CI]: 0.74-1.72). Over a median follow-up of 3.7 years, there were no differences in recurrent ischaemic events between groups (HR 0.98, 95% CI: 0.82-1.16), nor significant interactions with prior beta blocker therapy. In patients who were on a beta blocker before the index MI, randomisation to no beta blocker (withdrawal) was not associated with an increased risk of ischaemic events during trial follow-up (composite ischaemic endpoint HR 0.93, 95% CI: 0.64-1.34).

CONCLUSIONS: In patients with MI and LVEF >40%, beta blocker withholding or withdrawal at discharge was not associated with increased short-term or recurrent ischaemic events, supporting the safety of this strategy in contemporary clinical practice.

PMID:40887991 | DOI:10.4244/EIJ-D-25-00826

Int J Nurs Pract. 2025 Oct;31(5):e70049. doi: 10.1111/ijn.70049.

ABSTRACT

AIM: To identify patterns and predictors of nurse turnover intentions based on years of nursing experience using a cluster analysis approach.

BACKGROUND: Nurses with varying years of experience have different characteristics. These differences can also lead to distinct patterns and predictors of turnover intentions.

METHODS: For this descriptive study, 785 nurses from hospitals across different regions of Türkiye participated in a survey. Data was collected through online questionnaires between April and May 2022. The K-means unsupervised machine learning algorithm was employed to classify nurses into distinct clusters based on their experience. Multiple linear regression analyses were conducted to identify the predictors of turnover intention specific to each cluster. The STROBE guideline was followed for reporting.

RESULTS: Cluster analysis grouped nurses into three categories by experience level: low, medium and high. The medium-experience group had the highest turnover intention, whereas the high-experience group had the lowest. Work stress was the only common predictor across all groups. Low income predicted turnover only for the low-experience group, and gender was significant only for the medium-experience group.

CONCLUSION: This study revealed that turnover intention and its predictors vary by experience level, indicating a need for retention strategies tailored to nurses’ years of experience. By considering subgroup characteristics, policymakers can develop targeted interventions to enhance nurse retention.

PMID:40887975 | DOI:10.1111/ijn.70049

Scand J Caring Sci. 2025 Sep;39(3):e70101. doi: 10.1111/scs.70101.

ABSTRACT

BACKGROUND: The Managerial Ethical Profile (MEP) scale was developed to measure the perceived impact of different elements of common ethical frameworks on managerial ethical decision-making.

AIM: To translate, culturally adapt and perform preliminary psychometric testing of the MEP scale in the Finnish health and social care sector.

DESIGN: The MEP scale was translated and culturally adapted according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) protocol based on a cross-sectional online survey.

PARTICIPANTS: Finnish health and social care managers and experts.

ETHICAL CONSIDERATION: Research permits were obtained from all participating organisations in accordance with the organisations’ guidelines. Participation was voluntary and participants gave informed consent.

METHODS: Translation and cultural adaptation of the Finnish version of the MEP scale (MEP-Fin) was performed and perceived relevance and content validity were assessed. An online survey was distributed to homecare service managers in 2022, and a total of 68 managers participated. The data were analysed using descriptive statistics (means, standard deviations, Pearson’s correlation coefficients and Cronbach’s alphas).

RESULTS: The translation, cultural adaptation and preliminary psychometric testing process identified issues regarding the understanding of the MEP scale in the Finnish context. The MEP-Fin showed high overall content validity (S-CVI/Ave 0.91). The mean score for the comprehensibility of the scale was 8.4. Content validity was high for all individual items (I-CVI range: 0.56 to 1.00), except for one item (0.38). The Cronbach’s alphas for the eight subscales were between 0.51 and 0.93, and for the whole scale, 0.84.

CONCLUSIONS: The systematic translation and cultural adaptation process resulted in a conceptually equal MEP-Fin, which was perceived as thorough and relevant. It showed good coverage, content validity and internal consistency. Preliminary psychometric testing provided information on the characteristics of the MEP-Fin for validation. Further studies with larger data sets and different cultures are needed.

PMID:40887714 | DOI:10.1111/scs.70101

Ear Nose Throat J. 2025 Aug 31:1455613251374489. doi: 10.1177/01455613251374489. Online ahead of print.

ABSTRACT

BACKGROUND: Microplastics are widespread in nature and have been detected in various human tissues and organs. They are thought to contribute to the occurrence and development of various diseases.

OBJECTIVES: To explore the relationship between microplastic exposure and allergic rhinitis (AR).

MATERIALS AND METHODS: Thirty-three patients with AR and 22 individuals in the control group were included in this study. All the participants completed the total nasal symptom score (TNSS) and nasal irrigation. The nasal irrigation solution was under microplastic analysis.

RESULTS: There were no significant differences in age and gender between the AR group and the control group. A statistically significant difference was noted in the TNSS questionnaire scores between the groups (P < .001). The density of microplastics in individuals with AR was significantly higher than that in the control group (9.96 (7.04-12.19); 7.22 ± 2.63; P = .003).

CONCLUSIONS AND SIGNIFICANCE: The concentration of microplastics in the nasal cavities of patients with AR was significantly higher than that in healthy individuals.

PMID:40887712 | DOI:10.1177/01455613251374489

Ying Yong Sheng Tai Xue Bao. 2025 Aug;36(8):2379-2387. doi: 10.13287/j.1001-9332.202508.006.

ABSTRACT

We examined the responses of leaf functional traits and their adaptation strategies of four dominant species (Lespedeza davurica, Carex duriuscula, Potentilla chinensis, and Cleistogenes chinensis) to desertification in the Zhanggutai desertified grassland, Liaoning Province. We measured the morphological and chemical functional traits under five desertification levels (0%, 10%, 30%, 50%, and 70% of sand addition by mass). The results showed that desertification significantly affected leaf functional traits in the natural grasslands of northwestern Liao-ning, but with significant species-specific difference. With the increases of desertification intensity, specific leaf area of C. duriuscula and P. chinensis increased initially and then decreased, peaking at 30% and 10% sand addition levels, respectively. Leaf dry matter content of the four species all showed a decreasing trend with aggravated desertification, but the changes were not statistically significant. Desertification significantly increased leaf N and P contents of C. duriuscula and C. chinensis, with N content being increased by 45.8% and 28.2%, and P content being increased by 87.1% and 50.3%, respectively under 70% sand addition treatment. The four species adapted to desertification through trade-offs among morphological and chemical traits. P. chinensis exhibited a “low-input, high-benefit” resource-conservative strategy. L. davurica maintained relatively stable leaf nutrient content. Both species exhibited a relatively strong adaptability to desertification.

PMID:40887687 | DOI:10.13287/j.1001-9332.202508.006

Matern Health Neonatol Perinatol. 2025 Sep 1;11(1):26. doi: 10.1186/s40748-025-00222-x.

ABSTRACT

This pilot randomized trial study evaluated the effectiveness of the Pebbles of Hope Thrive Guide, an interactive educational course designed for parents of premature infants. The study assessed changes in breastfeeding practices, maternal nutrition, and use of Kangaroo Care among 50 mothers in total randomized to one of three groups: Supervised, Independent, or Control. The purpose of the study was to assess the provision of mother’s breast milk, improved material nutrition behaviors, and adoption of Kangaroo Care among mothers that received access to the course compared to those that received standard education without Thrive Guide access. The primary outcome assessed was the provision of breast milk at three months post-intervention, while secondary outcomes included improvements in maternal confidence, changes in maternal nutrition behaviors, the adoption and frequency of providing Kangaroo Care, and the impact of educator supervision. Although the intervention improved mothers’ confidence and knowledge, it did not significantly impact breast milk provision or maternal nutrition behaviors at 3 months. Breast milk provision declined across all groups, but the amount of decline was not statistically different between them. Similarly, no significant differences were observed in the number of nutritional improvements made between the two periods. However, Independent users exhibited a notable increase in Kangaroo Care frequency. Qualitative interviews highlighted the importance of ongoing support and addressing practical barriers to following nutritional guidelines. These findings suggest that further research is needed to explore the conditions that enhance long-term behavior change and to identify strategies that optimize the impact of educational interventions on caregiving practices.

PMID:40887668 | DOI:10.1186/s40748-025-00222-x

J Health Popul Nutr. 2025 Aug 31;44(1):317. doi: 10.1186/s41043-025-01063-2.

ABSTRACT

OBJECTIVE: The present study aimed to evaluate the association between advanced lung cancer inflammation index (ALI) and all-cause mortality in a population of patients with Coronary Heart Disease(CHD) using a retrospective cohort study design.

METHODS: Data were obtained from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). ALI was calculated as BMI × albumin level ÷ NLR, integrating anthropometric, nutritional, and inflammatory biomarkers. History of CHD was obtained using a questionnaire. We used Cox regression analysis to explore potential relationships and examined the nonlinear relationship using Restricted Cubic Splines (RCS).

RESULTS: A total of 1,295 participants were included in the study. Cox regression results revealed that a higher ALI was associated with lower all-cause mortality in patients with CHD. The subgroup and interaction analyses showed that the results were consistent. After adjusting for all covariates, participants in quartile 4 of ALI showed a 39% reduction in all-cause mortality compared to quartile 1. RCS analysis indicates a U-shaped relationship with a breaking point of 117.33.

CONCLUSION: In the United States, higher ALI was associated with lower all-cause mortality among patients with CHD. These findings suggest a potential association between ALI and all-cause mortality in CHD patients that warrants further investigation in prospective studies. Future interventional studies are needed to determine whether strategies targeting the components of ALI could improve clinical outcomes in this population.

PMID:40887663 | DOI:10.1186/s41043-025-01063-2

BMC Psychol. 2025 Aug 31;13(1):992. doi: 10.1186/s40359-025-03189-8.

ABSTRACT

BACKGROUND: The number of college students in need of treatment for depressive symptoms far outweighs the resources of most counseling centers due to rising health needs. It is necessary to establish prevention and intervention strategies for college students. This study aimed to explore the associations between self-efficacy, e-health literacy, and depressive symptoms to guide college students in adopting preventive measures and potential interventions for managing depressive symptoms.

METHODS: This cross-sectional study randomly recruited 1500 students from two universities in Nantong City from May to December 2020. Participants’ demographic characteristics, self-efficacy, e-health literacy, and depressive symptoms were collected. The mediating effect of e-Health literacy was evaluated using the bootstrap resampling technique.

RESULTS: A total of 1388 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 50.29%. Higher self-efficacy and e-health literacy were all significantly associated with lower depressive symptoms. e-Health literacy partially mediated the association between self-efficacy and depressive symptoms, accounting for 26.6% of the total effect.

CONCLUSION: Improving self-efficacy and e-health literacy was associated with reducing depressive symptoms, with e-health literacy partially mediating the relationship between self-efficacy and depressive symptoms. Interventions for college students should focus on enhancing both self-efficacy and e-health literacy to help alleviate depressive symptoms.

PMID:40887657 | DOI:10.1186/s40359-025-03189-8

J Health Popul Nutr. 2025 Aug 31;44(1):314. doi: 10.1186/s41043-025-01059-y.

ABSTRACT

BACKGROUND: Epidemiological studies have suggested that dried fruit intake may be associated with a lower risk of breast cancer (BC), yet the genetic mechanisms underlying this association remain unclear. This study aimed to explore the potential genetic relationship between dried fruit intake and BC susceptibility.

METHODS: We conducted a comprehensive genetic analysis using genome-wide association study (GWAS) data for dried fruit intake and BC, focusing on individuals of European ancestry. We assessed genome-wide and region-specific genetic correlations using several complementary methods, including linkage disequilibrium score regression and regional genetic mapping. To identify shared genetic regions, we applied statistical approaches that integrate information across traits and improve the detection of common genetic signals.

RESULTS: Modest but statistically significant negative genetic correlations were observed between dried fruit intake and BC, including its subtypes. Regional analysis revealed shared signals across multiple chromosomal regions. Five candidate loci were consistently identified as shared between the traits, including BCL11A, MAD1L1, MLLT10, JMJD1C, and RP11-795H16.2.

CONCLUSION: This study provides evidence for a genome-wide genetic link between dried fruit intake and BC risk, identifying several loci that may be shared between the traits. These findings may help improve our understanding of BC development and offer preliminary leads for future dietary prevention and personalized interventions, pending further experimental validation.

PMID:40887646 | DOI:10.1186/s41043-025-01059-y

BMC Pregnancy Childbirth. 2025 Sep 1;25(1):900. doi: 10.1186/s12884-025-08078-x.

ABSTRACT

BACKGROUND: To investigate the impact of tenofovir disoproxil fumarate (TDF) withdrawal timing on elevated postpartum alanine aminotransferase (ALT) levels and breastfeeding in pregnant women who received TDF therapy to prevent mother-to-child transmission (MTCT) of hepatitis B virus (HBV) infection.

METHODS: All enrolled women began treatment with TDF during weeks 24-32 of pregnancy and were divided into three groups that stopped TDF at delivery (Group A), at 4 weeks postpartum (Group B), or at 12 weeks postpartum (Group C). The biochemical and virological markers of hepatitis B were regularly measured and compared. Binary logistic regression analysis was used to explore the risk factors of elevated ALT levels.

RESULTS: Elevated postpartum ALT levels were observed in 91 of the 160 patients, including 38 out of 59 (64.41%) in Group A, 27 out of 51 (52.94%) in Group B, and 26 out of 50 (54%) in Group C. The incidence of elevated ALT levels did not differ significantly among the three groups (P = 0.338). Moreover, there was no significant difference in the severity of elevated ALT levels among the three groups (P = 0.558). Binary logistic regression analysis showed that ALT at delivery was an independent risk factor for elevated ALT levels (odds ratio = 1.098, 95% confidence interval, 1.039-1.160, P = 0.001). ROC analysis identified ALT ≥ 23 U/L at delivery as the optimal cutoff (AUC = 0.703, 95% CI: 0.622-0.785) for predicting elevated postpartum ALT levels. Breastfeeding rates were significantly higher in Group A (79.66%) compared to Group B (25.49%) and Group C (42%), both P values = 0.000.

CONCLUSIONS: When TDF is used to prevent MTCT of HBV, withdrawal timing did not significantly affect overall ALT elevation patterns. However, early TDF withdrawal at delivery was associated with higher breastfeeding rates, and mothers with ALT levels ≥ 23 U/L at delivery may benefit from extended postpartum antiviral therapy.

PMID:40887644 | DOI:10.1186/s12884-025-08078-x