Nevin Manimala

Nurs Open. 2026 May;13(5):e70589. doi: 10.1002/nop2.70589.

ABSTRACT

AIMS: This study examined the relationship between alarm fatigue and turnover intention among dialysis nurses and investigated the mediating role of professional quality of life (ProQOL).

DESIGN: An analytical cross-sectional study was conducted.

METHODS: This study employed a nonprobability sample of 140 dialysis nurses from hospitals affiliated with Shahid Beheshti University of Medical Sciences in Iran in December 2024. Data for this study were collected via a multi-section survey. This research initially focused on identifying demographic and occupational variables. Section two employed the Alarm Fatigue Questionnaire; section three, the ProQOL scale; and section four, the Turnover Intention Questionnaire. Data analysis was carried out using IBM SPSS Statistics, version 27.0.

RESULTS: The mean scores for alarm fatigue and turnover intention were 34.02 (SD = 8.50) and 48.70 (SD = 11.66), respectively. Item-level means for alarm fatigue were 2.62 (SD = 0.65) on a 0-4 scale. Also, scores were 3.30 (SD = 0.81) for secondary traumatic stress (STS), 3.61 (SD = 0.90) for compassion fatigue (CF), 3.01 (SD = 0.78) for compassion satisfaction (CS), and 3.25 (SD = 0.78) for turnover intention on 1-5 Likert-type scales. Pearson’s correlation showed that alarm fatigue was positively correlated with STS, CF and turnover intention, and negatively correlated with CS. Multiple linear regression explained 62.9% of the variance in turnover intention; single marital status, CS, CF and STS were significant independent predictors. Path analysis showed a significant total association between alarm fatigue and turnover intention, a non-significant direct association, and a significant indirect association through ProQOL components, a pattern consistent with mediation by ProQOL.

CONCLUSIONS: Path analysis showed a pattern of associations consistent with ProQOL mediating the relationship between alarm fatigue and turnover intention. The association between alarm fatigue and turnover intention appeared to operate primarily in association with STS, compassion fatigue, and compassion satisfaction, although the cross-sectional design precludes causal inference. These findings are consistent with the hypothesis that improving ProQOL may be associated with a weaker link between alarm fatigue and turnover intention, though this should be confirmed in longitudinal studies.

PMID:42083829 | DOI:10.1002/nop2.70589

J Dermatolog Treat. 2026 Dec;37(1):2648406. doi: 10.1080/09546634.2026.2648406. Epub 2026 May 5.

ABSTRACT

BACKGROUND: Acne vulgaris is a chronic inflammatory disease and is one of the leading causes of dermatological morbidities among young adults. Doxycycline is widely recommended as first-line therapy for moderate to severe acne; however, its use is limited.

OBJECTIVE: To systematically compare the efficacy and safety of oral azithromycin pulse therapy versus doxycycline in patients with moderate to severe acne vulgaris.

METHODS: This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive literature search on different databases was performed. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models based on heterogeneity.

RESULTS: A total of 23 comparative studies comprising 2,769 patients were included. Pooled analysis demonstrated a statistically significant improvement in global acne severity favoring azithromycin (GAGS reduction: MD 1.81; 95% CI 1.28-2.34; I² = 0%). Azithromycin achieved a significantly greater reduction in non-inflammatory lesion counts (MD -7.56; 95% CI -14.33 to -0.79). No significant differences were observed in inflammatory lesion reduction (MD 1.08; 95% CI -0.03 to 2.18).

CONCLUSION: Oral azithromycin pulse therapy appears to have similar efficacy, better tolerability, and fewer side effects as compared to doxycycline.

PMID:42083799 | DOI:10.1080/09546634.2026.2648406

Bioinformatics. 2026 May 4:btag251. doi: 10.1093/bioinformatics/btag251. Online ahead of print.

ABSTRACT

MOTIVATION: Pedigrees reconstructed from biologically related ancient genomes have revealed many insights into (pre)history. To our knowledge, all reported ancient pedigrees have been primarily manually reconstructed, as existing pedigree reconstruction methods are ill-suited for the quality and nature of ancient DNA data.

RESULTS: We introduce repare, an open-source software method to automatically reconstruct pedigrees from inferred pairwise kinship relations, which are readily obtainable from ancient genomes. This method reconstructs pedigrees by iteratively incorporating pairwise kinship relations into a set of candidate pedigrees, with pruning and sampling to reduce its search space. It optionally considers supporting information such as haplogroups and skeletal age-at-death estimates. We evaluate this method on a variety of simulated pedigrees with varying error rates and missingness. We also use this method to reconstruct several published pedigrees that were originally manually reconstructed; for one, we present a potential alternative topology. repare optionally incorporates user-inferred pedigree constraints, enabling “human-in-the-loop” reconstruction workflows. Especially when used with these user-inferred constraints, we find that repare represents a powerful and flexible tool for ancient pedigree reconstruction.

AVAILABILITY AND IMPLEMENTATION: repare is freely available at https://github.com/ehuangc/repare. In addition, source code, benchmark scripts, and benchmark results used in this work are archived at https://doi.org/10.5281/zenodo.19716772.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:42083796 | DOI:10.1093/bioinformatics/btag251

Ann Afr Med. 2026 May 6. doi: 10.4103/aam.aam_723_25. Online ahead of print.

ABSTRACT

BACKGROUND: Media use among children is widespread, and its impact on various aspects of life is increasingly recognized. The growing availability of information technology gadgets has led to a notable rise in screen exposure among the young population. Despite this, limited research exists on the influence of screen time on academic performance, particularly in developing countries. The present study aimed to investigate the relationship between screen time and academic performance among children aged 8-15 years, specifically assessing the association between total screen exposure and scholastic achievement in this age group.

METHODS: This cross-sectional observational study was conducted among 400 students aged 8-15 years, randomly selected from two public and two private schools. Data on academic performance were obtained from teachers and verified through school records, while information on screen exposure was collected using a structured questionnaire. Statistical analysis was performed using SPSS software, employing Spearman’s correlation coefficient and Kruskal-Wallis tests to determine the relationship between screen exposure and academic performance.

RESULTS: The mean total screen time among participants was 147.8 min/day, with television accounting for the maximum share (67.5 min). A statistically significant association was observed between television screen time and academic performance (P = 0.013).

CONCLUSION: Screen exposure among children in the 8-15-year age group exceeded the American Academy of Pediatrics’ recommendations. Increased television viewing was significantly associated with poorer academic performance, highlighting the need for awareness and regulation of children’s screen use.

PMID:42083778 | DOI:10.4103/aam.aam_723_25

Ann Afr Med. 2026 May 6. doi: 10.4103/aam.aam_53_26. Online ahead of print.

ABSTRACT

INTRODUCTION: When a patient’s presentation raises suspicions for conditions other than diabetic kidney disease (DKD), such as sudden onset proteinuria <5 years after the onset of type 2 diabetes, proteinuria without retinopathy or neuropathy, acute kidney injury, active urinary sediment, or hematuria, clinically indicated kidney biopsies are typically carried out. Consequently, a high incidence of non-DKD (NDKD) in clinical biopsies from diabetes individuals is not unexpected. The purpose of the study is to investigate the clinical predictors, prevalence and histopathological spectrum of NDKD in patients with type 2 diabetes mellitus.

MATERIALS AND METHODS: Dayanand Medical College and Hospital in Ludhiana conducted this cross-sectional observational study. After taking informed consent, 43 patients with diabetes who were suspected of having NDRD had kidney biopsies based on either or both of the following criteria: (1) Hematuria (red blood cell [RBC] casts, RBC >5/hpf). (2) Unexpected elevations in serum creatinine of more than 2 mg/dL. (3) Nephrotic syndrome with sudden onset. (4) Renal failure without diabetic retinopathy (DR). (5) DM duration <5 years. (6) Nephrotic range massive proteinuria with normal renal function. (7) Normal or negligible proteinuria along with severe renal insufficiency (serum creatinine >2 mg/dL) (<500 mg/dL).

RESULTS: (1) Of the 43 patients, 24 (56.0%) had pure NDKD. Four patients (9.3%) had mixed renal disease, while 15 patients (35%) had DKD. (2) The most prevalent NDKD was acute interstitial nephritis (AIN) (12%), which was followed by immunoglobulin A (IgA) nephropathy, localized proliferative glomerulonephritis and crescentic glomerulonephritis (7.0% each). The most prevalent pathology observed in mixed renal disease was DN with AIN. (3) The duration of hypertension was 4.98 ± 2.86 years in the group without DKD and 8.07 ± 4.65 years in the group with DKD, both of which were statistically significant. (4) Compared to the DKD group, more patients in the NDKD group had shorter DM duration (<5 years). A greater proportion of individuals in the DKD group had DM for more than 10 years. (5) Compared to the NDKD group, there were more NPDR patients in the DKD group.

CONCLUSION: Since several diseases, including MN, IgA nephropathy and AIN, are frequently treatable or even curable, our study demonstrated the need for early suspicion and diagnosis of NDKD.

PMID:42083774 | DOI:10.4103/aam.aam_53_26

Stress Health. 2026 Jun;42(3):e70181. doi: 10.1002/smi.70181.

ABSTRACT

The effects of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) and its interactions on the development of sleep quality in adolescents were unclear. To investigate the effect of ACEs and PCEs on the developmental trajectories of sleep quality in adolescents and to examine the potential moderating role of PCEs on the effects of ACEs. This study was conducted based on Anhui Child & Adolescent Healthy Growth Cohort. Latent class growth analysis (LCGA) was applied to capture the developmental trajectory of sleep quality. Logistic regression analyses were conducted to determine the effects of ACEs and PCEs exposure on sleep quality trajectories. Interaction analyses were performed to explore the moderating role of PCEs on the impact of ACEs. A total of 877 adolescents were included in this study (mean age: 11.31 ± 1.63, 51.1% were boys). Adolescents with ACEs exposure showed higher risk of poor development of sleep quality and there was a positive dose-response relationship. Adolescents with a pattern of ‘high ACE levels’ exposure (OR: 3.74, 95% CI: 2.02-6.91) were more likely to experience poor sleep quality development. In contrast, adolescents with a pattern of ‘high PCE levels’ (OR: 0.50, 95% CI: 0.31-0.80) were less likely to experience poor sleep quality development. Moderate to high levels of PCEs exposure (3-7 PCEs) can significantly moderate the adverse effects of ACEs on sleep quality development. This study suggests that ACEs exposure adversely affects the development of sleep quality among adolescents, while PCEs can moderate this effect. These findings highlight the urgency of early screening and intervention for ACEs and emphasise the importance of implementing various strategies in early life to promote PCEs.

PMID:42083758 | DOI:10.1002/smi.70181

BMC Rheumatol. 2026 May 5;10(1):36. doi: 10.1186/s41927-026-00643-x.

NO ABSTRACT

PMID:42083017 | DOI:10.1186/s41927-026-00643-x

BMC Musculoskelet Disord. 2026 May 4. doi: 10.1186/s12891-026-09843-5. Online ahead of print.

ABSTRACT

BACKGROUND: Subtrochanteric femur fractures are challenging to treat due to complex anatomy and high mechanical stresses. Cephalomedullary nailing is the standard treatment, often performed with the patient supine on a traction table, but this can prolong setup and cause complications (pressure or nerve injuries). Lateral decubitus positioning without a traction table may facilitate reduction and reduce traction-related risks, yet comparative data in subtrochanteric fractures are limited. This study compared outcomes of lateral decubitus versus traction table positioning for subtrochanteric fracture nailing.

METHODS: A retrospective cohort study included 68 patients with subtrochanteric femur fractures treated with cephalomedullary nails. Patients underwent surgery supine on a traction table (n = 37) or in lateral decubitus without a traction table (n = 31). Operative metrics (entry point determination time, operative time, fluoroscopy duration, and blood loss) and postoperative outcomes (transfusion requirements, time to mobilization, complications, and final Harris Hip Score) were compared between groups.

RESULTS: Lateral decubitus positioning was associated with shorter entry-point determination time (median 2 vs. 7 min; p = 0.05), shorter operating-room time (80.3 ± 23.6 vs. 108.2 ± 23.2 min; p = 0.03), reduced fluoroscopy time (151.2 ± 19.2 vs. 178.2 ± 16.1 s; p = 0.03), and lower estimated blood loss (752 ± 346 vs. 1459 ± 611 mL; p = 0.01) compared with traction-table positioning. No statistically significant differences were observed in transfusion requirements, time to mobilization, final Harris Hip Score, or complication rates (all p > 0.05).

CONCLUSION: Compared with traction-table positioning, lateral decubitus cephalomedullary nailing was associated with better functional outcome, shorter operative and fluoroscopy times, and lower estimated blood loss, while union and complication rates were similar between groups. These findings suggest that lateral decubitus positioning is a viable alternative for subtrochanteric fracture fixation, particularly when traction-table setup may compromise operating-room efficiency. Given the observational design and potential confounding related to reduction techniques and surgeon factors, these findings should be interpreted as associations; prospective studies are warranted.

PMID:42083005 | DOI:10.1186/s12891-026-09843-5

BMC Med. 2026 May 4. doi: 10.1186/s12916-026-04900-1. Online ahead of print.

ABSTRACT

BACKGROUND: No epidemiological studies have systematically evaluated the associations between prenatal exposure to organophosphate esters and polychlorinated biphenyls and the risk of congenital heart disease (CHD) in offspring. Moreover, the potential modifying role of maternal B-vitamin status in persistent organic pollutants (POPs)-CHD associations has not been examined. We therefore investigated the cardiotoxic effects of prenatal POPs exposure and evaluated effect modification by maternal B-vitamin levels.

METHODS: A multicenter case-control study was conducted in China from 2016 to 2021, including 425 participants. Thirty POPs and seven plasma B vitamins were quantified using high-resolution mass spectrometry. Single-exposure associations were examined by logistic regression, while multipollutant effects were assessed through Bayesian kernel machine regression (BKMR) and Weighted Quantile Sum (WQS) models. Potential effect modification by B vitamins was systematically evaluated.

RESULTS: Prenatal exposure to p-cresyl diphenyl phosphate was associated with an increased risk of CHD (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.08, 1.71). Mixture analyses consistently showed an increasing trend in CHD risk with higher exposure to the POPs mixture, with the WQS model yielding a statistically significant association (OR = 1.20, 95% CI: 1.03, 1.40). Higher concentrations of pyridoxamine, pyridoxal, and vitamin B12 were inversely associated with CHD risk, and mixture analyses using both BKMR and WQS regression further demonstrated a significant negative association between the overall B-vitamin mixture and CHD risk. In the interaction analysis, B vitamins significantly modified the association between prenatal POPs exposure and CHD risk (OR = 0.14, 95% CI: 0.04, 0.52).

CONCLUSIONS: This study provides the first population evidence that prenatal POPs exposure is associated with increased CHD risk and adequate maternal B-vitamin levels may attenuate the developmental cardiotoxicity of emerging flame retardants, highlighting the importance of maternal nutritional status in modifying environmental risk factors for CHD.

PMID:42083004 | DOI:10.1186/s12916-026-04900-1

BMC Med Educ. 2026 May 4. doi: 10.1186/s12909-026-09376-4. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to evaluate the feasibility, acceptability, and diagnostic utility of a structured Medical Licensing Examination (MLE) preparatory course designed for Saudi medical interns. The evaluation focused on assessing the program participants’ readiness by evaluating their knowledge, test-taking skills, and participant satisfaction.

METHODS: This convergent mixed-methods evaluation design study was carried out at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. The entire cohort of 103 interns was included. The preparatory program was organized into a three-phase process. The initial planning phase involved identifying student needs and designing the course. This was followed by the implementation phase, which focused on delivering the course through interactive learning sessions and practice examinations. The final evaluation phase was dedicated to assessing participant satisfaction, gathering feedback, and analyzing benefits. For data collection, the researchers developed a questionnaire to assess satisfaction and administered a post-course mock examination as formative tool to measure the interns’ knowledge and readiness for the licensing exam. Data analysis integrated descriptive statistics for numerical data with thematic analysis for open-ended responses.

RESULTS: Out of 76 interns, 67 (88.15%) reported high levels of satisfaction with all the sessions. Most participants agreed that the course objectives were clearly defined (n = 59, 77.6%) and that participation and interaction were encouraged (n = 75, 98.7%). The mean test score was 21.71 (43.42%), which suggests a relatively low level of preparation for this type of examination. Qualitative feedback further supported these findings, highlighting strengths in content delivery and instructional strategies.

CONCLUSION: The integration of the MLE preparation program and mock assessment within the medical curriculum offers a structured approach to familiarizing interns with the format and content of the licensure examination. Participant feedback suggests positive perceptions of the learning experience, while the mock assessment provided a useful diagnostic snapshot of performance at the time of administration. These findings describe the potential role of such interventions in supporting exam preparation.

PMID:42082995 | DOI:10.1186/s12909-026-09376-4