Nevin Manimala

J Contin Educ Nurs. 2026 Jan;57(1):21-28. doi: 10.3928/00220124-20251029-01. Epub 2026 Jan 1.

ABSTRACT

BACKGROUND: Training programs for cardiovascular specialist nurses in China lack standardized evaluation frameworks. This study developed a structured evaluation model based on the Workplace-Based Assessment (WPBA) guided by Miller’s Pyramid of clinical competence.

METHOD: A Delphi method was employed, involving 15 cardiovascular nursing education experts who participated in two consultation rounds. Initial evaluation items were derived from literature reviews and expert group discussions. Consensus and content validity were assessed using descriptive statistics and Kendall’s coefficient of concordance.

RESULTS: Experts achieved strong consensus, validating a comprehensive evaluation model comprising four integrated assessment components: theoretical knowledge examination, Mini-Clinical Evaluation Exercise (Mini-CEX), Direct Observation of Procedural Skills (DOPS), and Case-Based Discussion (CBD). Each assessment aligns with one level of Miller’s Pyramid, ensuring a comprehensive evaluation from theoretical knowledge to clinical performance. Consensus analysis demonstrated high expert agreement and consistency across assessment criteria and clinical sites.

CONCLUSION: This structured assessment model addresses existing gaps in advanced nursing education, offering standardized and objective evaluations of trainee competencies. This evaluation framework contributes substantially to advancing nursing education and enhancing cardiovascular health care quality through better trained specialist nurses.

PMID:41460504 | DOI:10.3928/00220124-20251029-01

J Relig Health. 2025 Dec 29. doi: 10.1007/s10943-025-02502-4. Online ahead of print.

ABSTRACT

Little discussion of including the spiritual domain in physical therapy (PT) education in the US has occurred despite support from PT practitioners and students. The purpose of this study was to assess the perceptions of practicing physical therapists regarding the role that their own spirituality, prior professional education, and the usefulness of including spirituality in PT practice may play in several aspects of clinical practice. A random sample of 800 physical therapists working in acute/sub-acute rehabilitation settings selected from the APTA membership was surveyed. This cross sectional study achieved a response rate of 57.5% (n = 460). Outcomes consisted of 57 Likert-scale items focused on the role that spirituality might play in PT clinical practice. Internal consistency reliability of these items was excellent (α = .97). The importance of including spirituality in patient care (total score) was significantly related to respondents’ self-identified belief system (where religious/spiritual were more positive relative to atheist/agnostic/other) (p < 001/h2 = .178) andperceptions of usefulness of including spirituality in patient care (where positive perceptions related to positive outcomes) (p < .001/d = -1.856). Although those with prior exposure to spirituality through professional education tended to agree more with the outcomes, only three of the five topic areas were statistically significant, but the total score was not significantly related (p = .237/d = -.154). Study results contribute to the existing literature supporting the importance of addressing spirituality in PT education. Educating physical therapists in this area would enhance the profession’s goal of providing holistic patient-centered care and improving cultural competence.

PMID:41460478 | DOI:10.1007/s10943-025-02502-4

Can J Public Health. 2025 Dec 29. doi: 10.17269/s41997-025-01143-0. Online ahead of print.

ABSTRACT

OBJECTIVES: Latin Americans are among the fastest-growing racialized groups in Canada but remain largely invisible in cancer surveillance and research. This study examines cancer diagnosis among Latin Americans compared to non-Latin American White and other racialized populations and explores how diagnosis varies across sociodemographic subgroups.

METHODS: Secondary analysis of pooled data from the Canadian Community Health Survey (2015-2018) was conducted. The analytic sample included 177,754 adults aged 18 or older, of whom 1799 identified as Latin American. Logistic regression models estimated the association between ethnicity and self-reported cancer diagnosis, with interaction terms testing moderation by sex, education, income, and immigration status.

RESULTS: Latin Americans had lower odds of reporting a cancer diagnosis than non-Latin American Whites (OR = 0.69; 95% CI, 0.52-0.92). Subgroup analyses showed stronger protection among males than females, those with mid-range incomes compared to lower or higher earners, and immigrants relative to Canadian-born Latin Americans. Individuals with graduate or limited secondary education also showed greater protection than other education levels.

CONCLUSIONS: While Latin Americans in Canada appear to experience a protective advantage in overall cancer prevalence, this advantage is not uniform. Disparities persist across sex, socioeconomic position, and immigration status, pointing to structural inequities that remain despite universal coverage. Equity-oriented cancer prevention strategies-including culturally tailored outreach, improved screening access, and systematic collection of race and ethnicity data-are needed to ensure that Latin Americans are not rendered invisible in Canadian cancer care.

PMID:41460463 | DOI:10.17269/s41997-025-01143-0

Indian J Gastroenterol. 2025 Dec 29. doi: 10.1007/s12664-025-01888-z. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Risk stratification of patients with upper gastrointestinal bleeding (UGIB) is crucial for streamlining healthcare in resource-limited settings, thereby minimizing both morbidity and mortality. Our objective was to validate clinical outcomes of the pre-existing risk assessment scores as full Rockall score (FRS), Glasgow-Blatchford bleeding score (GBS), Progetto Nazionale Emorragia Digestiva (PNED) and AIMS65 (an acronym of albumin, International Normalized Ratio [INR], mental status, systolic blood pressure, age > 65 years) scores and a proposed acronymic A2BC score incorporating four variables as age, serum albumin, mean blood pressure and serum creatinine in our setting.

METHODS: Prospective study over a three-year period of patients presenting with UGIB at the Department of Medical Gastroenterology, Medical College, Kolkata.

RESULTS: The mean age of the 535 subject population was 52.84 ± 17.13 years, with male predominance (n = 284, 53.08%) and a majority being non-variceal bleeders (n = 336, 62.8%). The median (IQR) of FRS, GBS, PNED, AIMS65 and A2BC scores with composite risk defined as the presence of one or more of the following: need for blood transfusion during hospitalization, therapeutic intervention in non-malignant NVUGIB, rebleeding and death both within 42 days were 4 (3-6), 14 (12-16), 6 (2-10), 1 (0-2) and 1 (0-2) in comparison to those without the risk 2 (2-3), 10 (8-11), 3 (0-4), 0 (0-0) and 0 (0-0), respectively, all of which were statistically significant (p < 0.001). The discriminant cut-offs of FRS, GBS, PNED, AIMS65 and A2BC scores to predict composite risk of the subjects were ≥ 2, ≥ 7, ≥ 1, ≥ 1 and ≥ 1, respectively, with accuracies of 64.85%, 68.97%, 68.59%, 73.83%, and 77.57% respectively.

CONCLUSION: Our study validates the commonly used prognostic scores in our context and encourages further studies on the newly formulated A2BC score.

PMID:41460457 | DOI:10.1007/s12664-025-01888-z

Indian J Gastroenterol. 2025 Dec 29. doi: 10.1007/s12664-025-01821-4. Online ahead of print.

ABSTRACT

BACKGROUND: Phenotyping of gastroesophageal reflux disease (GERD) requires endoscopy, high-resolution esophageal manometry (HREM) and 24-hour pH testing.

METHODS: The present study was conducted to determine HREM parameters associated with positive reflux test (acid exposure time > 4% on 24-hour pH test). Further, creation and validation of manometry GERD score (MGS) to predict positive reflux test was done. Consecutive patients > 18 years referred for HREM and 24-hour pH study between May 2019 and December 2024 were included prospectively. Based on the findings in patients enrolled between May 2019 and May 2022, HREM parameters significantly different in patients with and without positive reflux were noted. Based on odds ratio, each parameter was assigned weightage points to formulate MGS. This score was validated prospectively. Data was analyzed for sensitivity, specificity, positive-predictive value (PPV), negative-predictive value (NPV) and area under the receiver-operating characteristic (AUROC) curve. Optimal cut-off was interpreted based on Index of Union test. A p value < 0.05 was considered statistically significant.

RESULTS: Calibration cohort included 144 patients (90 males)-98 (68%) had positive reflux test. Patients with positive reflux test had higher incidence of abnormal multiple rapid swallows (MRS, p 0.006), esophagogastric junction (EGJ) contractile integral (CI) < 39 (p < 0.0001) and type 2/3 EGJ morphology (p < 0.0001). These parameters were allotted weightage points to formulate MGS (total 5 points). In the validation cohort (n = 151, 95 males), 65 (43%) patients had a positive reflux test. A majority of patients with positive reflux test had MGS > 3.5 (83.1%). MGS score had AUROC equal to 0.85. MGS > 3.5 had sensitivity of 83.1% and specificity 80.2% to detect positive reflux test.

CONCLUSION: EGJ morphology type 2/3, EGJ-CI < 39 mmHg and abnormal MRS were significantly more common in patients with positive reflux test. MGS is useful in predicting positive reflux test.

PMID:41460456 | DOI:10.1007/s12664-025-01821-4

Discov Ment Health. 2025 Dec 29;5(1):202. doi: 10.1007/s44192-025-00333-z.

ABSTRACT

BACKGROUND: High stress affects mental and physical health, with African Americans at greater risk due to systemic inequities. The Community Resiliency Model (CRM)^®, an evidence-based intervention teaching sensory awareness skills to enhance resiliency, was evaluated among African American and White elderly participants with memory impairment to assess its effectiveness on stress-related outcomes.

METHODS: Fifty-four African American and White participants with mild cognitive impairment (MCI) were recruited in Atlanta, Georgia, for a 3-h online CRM workshop in 2021-2022 delivered by a CRM-trained nurse practitioner. Participants completed surveys pre- and 4 weeks post-intervention, including Perceived Stress Scale (PSS-10), Patient Health Questionnaire (PHQ-9), Somatic Symptoms Scale (SSS-8), and Connor-Davidson Resilience Scale (CD-RISC-10). Paired t-tests assessed the changes in outcome measures.

RESULTS: Among fifty-four participants, twelve were lost to follow-up. Mean age was 68 (range: 39-83 years); majority were female (81%) and African American (71%). Participants showed improvements in mean differences for depressive symptoms (PHQ-9 difference: 1.4; [95% CI 0.5, 2.4]; p-value = 0.0035), somatic symptoms (SSS-8 difference: 1.9; [95% CI 0.81, 3.0]; p-value = 0.0011), and resilience (CD-RISC-10 difference: – 1.4; [95% CI – 2.8, – 0.0026]; p-value = 0.05). Perceived stress improved but was not statistically significant (PSS-10 difference: 1.0; 95% CI – 0.77, 2.9; p-value = 0.25). No racial differences were observed.

CONCLUSION: CRM can enhance mood, alleviate somatic symptoms, and improve resilience in elderly participants with memory concerns. It shows promise as a brief, accessible intervention for mental well-being in diverse populations. Larger studies are needed for generalizability, given the limited sample size.

PMID:41460432 | DOI:10.1007/s44192-025-00333-z

Aging Clin Exp Res. 2025 Dec 29;38(1):8. doi: 10.1007/s40520-025-03241-y.

ABSTRACT

BACKGROUND: Cognitive impairment may hinder effective self-management of cardiovascular disease and lead to worsening cardiovascular risk.

AIMS: This study aimed to describe the rate of uncontrolled blood pressure, blood lipids, and blood glucose across different cognitive levels to identify priority groups for managing risk factors in patients with cardiovascular disease.

METHODS: A total of 10,707 patients with cardiovascular disease or individuals at high cardiovascular risk were enrolled from Beijing Anzhen Hospital. Cognitive function, assessed using the Montreal Cognitive Assessment (MoCA) scale, was categorized as normal (MoCA ≥ 26) or impaired (MoCA < 26). Logistic regression was used to explore the association between cognitive function and the rates of uncontrolled blood pressure, lipids, and glucose.

RESULTS: Among diabetic patients, the rate of uncontrolled blood glucose in those with cognitive impairment was significantly higher in patients with cognitive impairment than in those with normal cognition [hemoglobin A1c ≥ 7%, 65.7% vs. 56.6%, adjusted odds ratio (aOR) (95% confidence interval, 95% CI):1.40(1.21-1.62), P < 0.001]. The rate of uncontrolled blood pressure and blood lipids were slightly higher in cognitive impairment than normal cognition, however, the differences were not statistically significant [systolic blood pressure(SBP) ≥ 130mmHg and/or diastolic blood pressure(DBP) ≥ 80mmHg, 74.6% vs. 70.5%, aOR(95% CI):1.07 (0.96-1.20), P = 0.206; SBP ≥ 140mmHg and/or DBP ≥ 90mmHg, 45.4% vs. 40.0%, aOR(95% CI):1.08(0.98-1.91), P = 0.125; poor blood lipids management, 72.2% vs. 70.5%, aOR (95% CI):1.00(0.89-1.13), P = 0.994].

CONCLUSIONS: In this cross-sectional study, a significant association was observed between cognitive impairment and an unfavorable cardiovascular risk profile. This may reflect challenges in self-management and underscores the need for proactive care.

PMID:41460429 | DOI:10.1007/s40520-025-03241-y

J Robot Surg. 2025 Dec 29;20(1):127. doi: 10.1007/s11701-025-03094-7.

ABSTRACT

The purpose of this study was to evaluate the safety and efficacy of perioperative outcomes of the KangDuo Surgical Robot System versus the Da Vinci System in robot-assisted renal surgery. We conducted a comprehensive systematic search in key databases including PubMed, the Cochrane Library, Embase, and Web of Science, encompassing studies in all languages, with the final search date being October 2025. We also excluded articles comprising reviews, letters, and single-arm studies. Variables were assessed using metrics of Weighted Mean Difference (WMD), Standardized Mean Difference (SMD), and Odds Ratio (OR). The statistical synthesis of the data, encompassing diverse outcome measures, was conducted utilizing the Review Manager software. Moreover, the protocol for this systematic review and meta-analysis is publicly available on PROSPERO (Registration number: CRD420251181530). In a pooled analysis of 370 participants from five trials, the KangDuo Surgical Robot System demonstrated a significantly extended docking time relative to the Da Vinci System (SMD = 1.55, 95% CI: 1.21-1.90; p < 0.00001). Conversely, comparisons of operative time, estimated blood loss, incidence of minor complications, ischemia time, and postoperative renal function (assessed by 4-week serum creatinine and eGFR) yielded comparable results, with no statistically significant differences. In this meta-analysis with limited sample size, geographic focus on Chinese centers, and short-term follow-up, the pooled data indicate that the KangDuo (KD) Surgical Robot System achieved non-inferiority to the Da Vinci System on several key perioperative metrics in robot-assisted renal surgery, although with a longer docking time. These findings support the KD system as a promising alternative in comparable settings, yet they should be interpreted within the constraints of the available evidence. Future research, particularly large-scale, multicenter randomized trials with long-term monitoring of survival and renal function, is necessary to confirm its efficacy and safety profile for widespread clinical adoption.

PMID:41460419 | DOI:10.1007/s11701-025-03094-7

J Gastrointest Cancer. 2025 Dec 29;56(1):247. doi: 10.1007/s12029-025-01369-8.

ABSTRACT

PURPOSE: Gallbladder cancer is the fifth most common gastrointestinal cancer worldwide, often diagnosed incidentally after cholecystectomy for presumed benign disease. Previous studies have reported geographic variations in the incidence of incidental gallbladder cancer (IGBC), but comprehensive pooled estimates examining multiple predictors of IGBC are lacking. The study aims to synthesize the risk factors and clinical predictors associated with IGBC in patients undergoing cholecystectomy for benign gallbladder conditions.

METHODS: This systematic review and meta-analysis assessed studies published between January 2010 and February 2024 in databases from EMBASE, PUBMED-MEDLINE, and Scopus. Eligible studies included observational study designs evaluating risk or predictive factors for IGBC diagnosed during or after cholecystectomy for presumed benign gallbladder disease. Heterogeneity across studies was assessed using the I² statistic. Sensitivity analyses were conducted to explore the robustness of the pooled estimates.

RESULTS: Of 2899 studies screened, 18 were included in the systematic review and 9 of these were included in the meta-analysis, covering 788,214 patients undergoing cholecystectomy. Advancing age (OR:1.09; 95% CI:1.07-1.12, I²=55.9%), female gender (OR:1.91; 95% CI:1.33-2.75, I² = 72.1% ), elevated alkaline phosphatase (OR:1.68; 95% CI:1.41-2.00, I² = 0%), polyp size > 10 mm (OR:8.63; 95% CI:1.95-38.26, I² = 0%), and open cholecystectomy (OR:9.20; 95% CI:5.68-14.89, I² = 83.5%) were found to have association with IGBC. Large gallstones (> 3 cm) showed no significant association. Risk of bias was low, and sensitivity analyses confirmed model robustness.

CONCLUSION: This review identifies key demographic, and clinical factors associated with IGBC. These findings support the need for risk-based preoperative evaluation and careful intraoperative vigilance, particularly in patients with advanced age, female gender, elevated alkaline phosphatase, and larger gallbladder polyps. Incorporating these predictors into clinical decision-making may guide targeted histopathological examination policies, leading to earlier GBC detection and improved patient outcomes. PROSPERO Registration No: CRD42024528982.

PMID:41460407 | DOI:10.1007/s12029-025-01369-8

J Robot Surg. 2025 Dec 29;20(1):126. doi: 10.1007/s11701-025-03012-x.

ABSTRACT

This study aims to systematically examine how minimally invasive thymectomy-covering both video-assisted and robotic-assisted methods-compares with open thymectomy in terms of perioperative safety and effectiveness for treating large thymomas. We thoroughly searched several databases for relevant studies, including randomized controlled trials and cohort studies, published up until October 2025. Data on perioperative factors, including surgical duration, blood loss, length of hospitalization, complications, and recurrence rates, were extracted and analyzed using random-effects models in STATA 18. Seven studies involving 12,880 patients were included. open surgery showed significantly more blood loss (WMD = 110.43, 95% CI 105.83-115.03; P < 0.05), longer hospital stays (WMD = 2.04, 95% CI 1.38-2.7; P < 0.05) compared to MIT. No notable difference in surgical duration was observed. Moreover, minimally invasive thymectomy (MIT) was associated with a reduced rate of recurrence after surgery (OR = 0.54, 95% CI 0.35-0.84; P < 0.05) as well as fewer postoperative complications (OR = 0.27, 95% CI 0.19-0.39; P < 0.05). MIT offers significant advantages over open surgery for large thymomas, including reduced blood loss, shorter hospital stays, and lower rates of complications and recurrence, though operative time was similar. Further large-scale studies are needed to confirm these findings and assess long-term efficacy.

PMID:41460396 | DOI:10.1007/s11701-025-03012-x