Nevin Manimala

BMC Health Serv Res. 2025 Sep 5;25(1):1191. doi: 10.1186/s12913-025-13396-z.

ABSTRACT

BACKGROUND: Adverse events resulting from medical care continue to be a significant cause of morbidity and mortality globally. Many individuals experience harm due to medical errors, particularly in developing nations. The primary objective of this study was to evaluate the patient safety culture among pharmacy professionals employed in public hospitals within Bahir Dar City, Ethiopia.

METHODS: A descriptive institutional-based cross-sectional study was conducted between March 2024 and April 2024. The Pharmacy Survey on Patient Safety Culture (PSOPSC) assessment tool was administered to all pharmacy professionals working at the three public hospitals. The data was analysed using Statistical Package for the Social Sciences (SPSS) version 26, followed by univariable and multivariable logistic regression analyses to identify predictors. Variables with a P value < 0.05 at a 95% Cl in the multivariable analysis were declared statistically significant.

RESULTS: Of the 118 participants, 110 responded, resulting in a response rate of 93.2%. The positive response rates for the 11 patient safety culture dimensions varied from 40.91-70.61%. According to the Agency for Health Research and Quality (AHRQ) guidelines, the average positive response rate was moderate at 59.09%. The lowest positive response rate was for ‘communication about mistakes’ at 40.91%, while ‘teamwork within a unit area’ had the highest positive response rate of 70.61%. The seven dimensions that fell within the AHRQ standard had a moderate positive response rate, ranging from 50.3 to 69.69%, whereas ‘teamwork within a unit area’ (70.61%) and ‘response to mistakes’ (70.45%) had a high positive response rate within the high positive response rate of the AHRQ standard (≥ 70.0%). However, two other dimensions, ‘communication about mistakes’ (40.91%) and ‘communication openness’ (48.47%) had a low positive response rate within the low positive response rate of the AHRQ standards (< 50.0%). Of the participants, 30.9% reported at least one event over the past year, while 37.3% rated the level of patient safety as ‘very good or excellent’. Several factors were found to have a significant association with the level of positive response rate on patient safety culture, including educational level, years of working experience in the hospital and unit area, direct interaction with patients, patient safety training, and five dimensions of patient safety culture: staff training and skills, communication openness, communication about prescriptions across shifts, communication about mistakes, and physical space and environment.

CONCLUSIONS: A moderate level of patient safety culture indicated that targeted interventions are required to address key areas contributing to this moderate positive response rate. To create effective hospital pharmacy settings, teamwork, leadership skills, effective communication, employee counseling, adequate staffing, prompt response procedures, and accurate reporting protocols are essential.

PMID:40913230 | DOI:10.1186/s12913-025-13396-z

J Adv Nurs. 2025 Sep 5. doi: 10.1111/jan.70190. Online ahead of print.

ABSTRACT

BACKGROUND: Research priorities guide research activities, funding and resources within health services. To ensure that research efforts are meaningful and impactful, it is vital that organisational research agendas reflect the priorities of both healthcare consumers and staff, alongside broader national and international research frameworks. This paper outlines a research priority-setting project conducted across two hospitals in Western Australia, aimed at identifying shared research priorities through a collaborative and inclusive approach.

AIM: To identify the top ten nursing and allied health research priorities for two hospitals in Western Australia.

METHODS: A modified James Lind Alliance Priority Setting Partnership approach was used, involving health services users, nurses, allied health professionals, and community members in a co-design approach across three phases. In phase 1, four community conversations were conducted to elicit an initial set of research topics. This data-informed phase 2, a survey to collect diverse views from a wider participant pool. In phase 3, a pre-selected sample of potential research priorities was discussed in a consensus workshop to reach a group consensus of the top ten research priorities. Qualitative data was analysed using multi-step thematic analysis, and quantitative data was analysed using descriptive statistics.

RESULTS: A total of 67, 151 and 18 people participated across study phases 1, 2 and 3, respectively, comprising nurses, allied health professionals, healthcare users, carers, and interested community members. The top ten research priorities reflected three areas: healthcare systems re/design (streamlining care; access to healthcare; patient journey and quality of care), workforce needs (workforce well-being, retention and adequate staffing; workforce training), and specific health issues and needs (dementia and delirium; mental health; caring for carers; Aboriginal and Torres Strait Islander health; palliative care and elderly people).

CONCLUSION: The research priorities identified in this study for two hospitals in Western Australia reflect the strong desire of nurses, allied health professionals, healthcare users and community members to improve structural issues in healthcare systems. This includes how healthcare systems are designed and integrated with each other, how workforce needs affect service delivery, and a greater focus on holistic service provision for specific health issues and needs.

PATIENT OR PUBLIC CONTRIBUTION: Healthcare consumers were an integral part of this study. Healthcare consumers were involved in the design of the study, the conduct of the study, and the review of the data analysis.

PMID:40913226 | DOI:10.1111/jan.70190

Ann Surg Oncol. 2025 Sep 5. doi: 10.1245/s10434-025-18219-3. Online ahead of print.

ABSTRACT

BACKGROUND: This systematic review and meta-analysis compared the intraoperative and postoperative outcomes of minimally invasive versus open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC), which is a highly aggressive tumor with a high mortality rate. Surgical resection remains the only potentially curative treatment. Minimally invasive distal pancreatectomy (MIDP), including laparoscopic and robotic approaches, has gained popularity, although the evidence of its efficacy is limited.

MATERIALS AND METHODS: PubMed, Scopus, and Web of Science databases were searched for studies that compared MIDP and ODP. Randomized clinical trials (RCTs) and observational studies were included. Risk ratio (RR) and mean difference (MD) with 95% confidence intervals (CI) were used to analyze the outcomes. Heterogeneity was assessed using the I² test, and statistical significance was set at p < 0.05. Analyses were conducted using the RStudio version 4.4.1.

RESULTS: A total of 20 studies with 9339 patients were included, of which 2219 (23.76%) underwent MIDP and 7120 (76.24%) ODP. MIDP was associated with reduced hospital stay (MD – 1.99; p < 0.000001), infections (RR 0.58; p = 0.001855), delayed gastric emptying (RR 0.48; p = 0.003677), blood loss (MD – 55.55; p = 0.000005), transfusions (RR 0.36; p < 0.000001), and 90-day mortality (RR 0.43; p = 0.001092). Other outcomes, including pancreatic fistula, complications according to the Clavien-Dindo classification, operative time, and reoperation, showed insignificant differences.

CONCLUSIONS: MIDP for PDAC offers better clinical outcomes than ODP, including reduced infections and transfusions. Further RCTs are needed to validate these findings and update the guidelines.

PMID:40913221 | DOI:10.1245/s10434-025-18219-3

Behav Res Methods. 2025 Sep 5;57(10):277. doi: 10.3758/s13428-025-02694-3.

ABSTRACT

The study of time-dependent within-person dynamics has gained popularity in recent years through the use of multilevel (latent) time-series models. However, due to the complexity of the models, model applications are usually limited with respect to the inclusion of time-varying moderating factors on the longitudinal within-person relations between variables. That is, in common applications of multilevel time-series models, the within-person dynamics of constructs over time are regarded as being insensitive to changes in other time-varying factors or changes in contexts. We illustrate an extension of multilevel latent time-series models that incorporate latent interaction effects at the dynamic within-person level. We build on previous work that incorporated time-varying observed or latent moderator variables for the dynamic parameters in vector autoregressive models and provide a tutorial for the application of the models, implemented and estimated using Bayesian estimation via Markov chain Monte Carlo techniques. The models are illustrated by two empirical applications that investigate the temporal dynamics of negative affect, rumination, and mindful attention. The performance of different models with varying complexity is investigated via several simulation studies to provide recommendations regarding the models’ applicability for applied researchers. Required sample sizes range between at least 25 time points for around 50 persons in the simplest fixed-effects models and at least 100 time points for at least 100 persons in random-effects factor models, depending on the expected effect sizes of the dynamic parameters.

PMID:40913220 | DOI:10.3758/s13428-025-02694-3

Eur Spine J. 2025 Sep 6. doi: 10.1007/s00586-025-09329-3. Online ahead of print.

ABSTRACT

PURPOSE: To compare the long-term clinical outcomes and radiographic findings between hybrid surgery (HS) and anterior cervical discectomy and fusion (ACDF) for three-level cervical degenerative disc disease (CDDD). And the incidence, prognosis, and potential risk factors of heterotopic ossification (HO) more than 10 years after Bryan prosthesis replacement in HS has been explored.

METHODS: From January 2007 to December 2014, a total of 46 patients who underwent either HS (n = 26) or ACDF (n = 20) for consecutive three-level CDDD were retrospectively analyzed. Clinical outcomes were assessed using the Visual Analogue Scale (VAS), Japanese Orthopaedic Association (JOA) score, and Neck Disability Index (NDI). Radiographic evaluations included cervical lordosis (CL), C2-7 range of motion (C2-7 ROM), ROM of surgical segments (SROM), and adjacent segment degeneration (ASD). Potential risk factors for HO development at the 10-year follow-up after HS, including age, sex, ossification of the anterior longitudinal ligament (OALL), and anterior vertebral osteophytes (AVO), were evaluated. Univariate analysis was followed by multivariate logistic regression to identify independent predictors. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of AVO for HO, including the area under the curve (AUC) and cutoff value. Spearman correlation was used to assess the relationship between ROM and ASD. Postoperative complications were also recorded.

RESULTS: The mean follow-up duration was 141.85 ± 17.20 months. Both groups demonstrated significant improvements in VAS, JOA, and NDI scores at 3 days postoperatively and at the final follow-up compared to preoperative values (P < 0.05). However, there were no statistically significant differences in these scores between the groups at any time point (P > 0.05). At the final follow-up, the HS group exhibited significantly greater C2-7 ROM and SROM compared to the ACDF group (P < 0.05). Both groups showed significant improvement in CL at postoperative day 3 compared to preoperative measurements (P < 0.05). At the 10-year follow-up, the incidence of ASD was lower in the HS group (53.85%) than in the ACDF group (75.00%), with a significant reduction in ASD severity (P < 0.05). A negative correlation between ROM and ASD was observed (P < 0.05). The rate of secondary surgeries was lower in the HS group (0% vs. 5.0%), though the difference was not statistically significant (P > 0.05). The overall prevalence of HO in the HS group was 26.92% (grades I-IV). Both sex and AVO were significantly associated with HO development, and multivariate analysis identified AVO as an independent risk factor (P < 0.05, β = 3.137). ROC curve analysis revealed that AVO had an AUC of 0.85 in predicting HO, with a cutoff value of 1.5.

CONCLUSIONS: Both HS and ACDF demonstrated favorable long-term clinical outcomes and effective reconstruction of cervical physiological curvature. However, HS better preserved cervical ROM. At the 10-year follow-up, HS demonstrated a trend toward a lower incidence of ASD compared to ACDF, and reduced the severity of progression of ASD. There was a trend toward fewer reoperation rates in HS. AVO proliferation was identified as a significant independent risk factor for HO after HS, whereas island-type OALL was not significantly associated with HO development. In clinical practice, preoperative evaluation of AVO in ACDR segments is essential to mitigate the risk of postoperative HO formation.

PMID:40913198 | DOI:10.1007/s00586-025-09329-3

Environ Sci Pollut Res Int. 2025 Sep 6. doi: 10.1007/s11356-025-36917-z. Online ahead of print.

ABSTRACT

Per- and poly-fluoroalkyl substances (PFAS) are fluorinated organic compounds known as forever chemicals that are used in many materials, from cooking appliances to industrial detergents. Given their high chemical stability due to their lipophilic properties and widespread use, PFAS tend to bioaccumulate in the cardiac, hepatic, renal, gastrointestinal, and neural tissues, resulting in a variety of malignant and non-malignant diseases. Depression is a prevalent mental health condition that affects an individual’s activities of daily living. Depression is associated with numerous other chronic diseases, as well as the exacerbation of those conditions. With the increasing exposure to PFAS, this study set out to further examine the toxic correlation of nine subtypes of PFAS with depression outcomes in the U.S. adult population. PFAS exposure was analyzed from serum laboratory samples from the National Health and Nutrition Examination Survey (NHANES) datasets from 2015 to 2018 and was analyzed via multiple linear regression and multiple logit regression approaches. Depression ratings were based on individual responses to the Patient Health Questionnaire (PHQ9) and then characterized as none (score of 0-4), mild (score of 5-9), moderate (score of 10-14), moderately severe (score of 15-19), and severe (score of 20-27). All statistical analyses are conducted with R software version 4.4.0. The observed correlation was significant for a subset of PFAS subtypes. The findings suggest a medium concentration exposure to branch perfluorooctanoic acid isomers (BFOA) (odds ratio (OR) 2.010; [95% confidence interval (CI), 1.013, 3.988]), a medium concentration exposure to n-perfluorooctanoic acid (NFOA) (OR 6.073; [95% CI, 1.069, 34.498]), and medium concentration exposure to perfluorononanoic acid (PFNA) (OR 3.992; [95% CI, 1.261, 12.632]) were positively correlated with depression occurrence in adults aged 20 years and older who were not incarcerated. Analyzed covariates that were most common among depressed individuals included being female; widowed, divorced, separated, or never married; having a BMI of obese; and a current smoker. Given the documented negative health effects and current research gaps, researchers should continue to analyze the effects of PFAS exposure while healthcare and governmental institutions disseminate education, encourage laboratory testing, and fund elimination efforts of PFAS exposure. More investigation is required to support or reject these findings.

PMID:40913187 | DOI:10.1007/s11356-025-36917-z

Nat Genet. 2025 Sep 5. doi: 10.1038/s41588-025-02326-8. Online ahead of print.

ABSTRACT

Gene expression is modulated jointly by transcriptional regulation and messenger RNA stability, yet the latter is often overlooked in studies on genetic variants. Here, leveraging metabolic labeling data (Bru/BruChase-seq) and a new computational pipeline, RNAtracker, we categorize genes as allele-specific RNA stability (asRS) or allele-specific RNA transcription events. We identify more than 5,000 asRS variants among 665 genes across a panel of 11 human cell lines. These variants directly overlap conserved microRNA target regions and allele-specific RNA-binding protein sites, illuminating mechanisms through which stability is mediated. Furthermore, we identified causal asRS variants using a massively parallel screen (MapUTR) for variants that affect post-transcriptional mRNA abundance, as well as through CRISPR prime editing approaches. Notably, asRS genes were enriched significantly among a multitude of immune-related pathways and contribute to the risk of several immune system diseases. This work highlights RNA stability as a critical, yet understudied mechanism linking genetic variation and disease.

PMID:40913182 | DOI:10.1038/s41588-025-02326-8

Surg Radiol Anat. 2025 Sep 5;47(1):199. doi: 10.1007/s00276-025-03704-x.

ABSTRACT

INTRODUCTION: Medical students primarily learn anatomy through lectures and atlases. Since mastering anatomy requires spatial visualization, dissection of cadavers has traditionally been regarded as the most effective approach in this discipline. Unfortunately, there are many drawbacks to this method, including accessibility issues. Nowadays, the use of 3D printing and other advanced technologies as educational tools in anatomy courses has been on the rise and they can play an extremely beneficial role in this regard. This study sought to evaluate the effectiveness of 3D printed anatomical models for student education.

MATERIALS & METHODS: The selected anatomical models were scanned using a 3D scanner, taking into account their 3D features and their application in hands-on learning settings. Minor modifications were made to the scanned files with the help of computer software before they were printed. Ultimately, the models were assessed by faculty members and students from different disciplines.

RESULTS: Once the models were prepared, they were given to various groups, including professors, medical students, MSc anatomy students, surgery residents, and BSc radiology students for evaluation. The opinions of these groups were then compared across two sets of models, and their assessments were analyzed in various cases. The feedback from four groups of students i.e. medical students, MSc anatomy students, surgery residents, and BSc radiology students indicated a notable contrast with the feedback from the professors’ group.

CONCLUSION: 3D printed models serve as valuable resources for teaching and learning anatomy from diverse viewpoints, catering to learners at different levels of study. Nevertheless, despite the usefulness of 3D models, anatomy professors believe that natural specimens associated with cadavers remain the most essential teaching resource for anatomy.

PMID:40913166 | DOI:10.1007/s00276-025-03704-x

Eur J Pediatr. 2025 Sep 5;184(9):601. doi: 10.1007/s00431-025-06433-w.

ABSTRACT

Long-term lead exposure damages the central nervous system, with chronic poisoning strongly linked to intellectual developmental disability (IDD) and disproportionately affecting children and adolescents. Using the Global Burden of Disease (GBD) 2021 database, this study analyzed temporal, spatial, and population-specific trends in lead-attributable IDD burden among global children/adolescents (1990-2021) and projected trends to 2040 to inform global public health strategies. GBD 2021 data characterized global, regional, and national distributions of lead-attributable IDD burden. Associations with sex, age, and Socio-Demographic Index (SDI) were evaluated via Years Lived with Disability (YLDs) and Age-Standardized YLD Rate (ASYR). Joinpoint regression quantified annual burden changes, and the Nordpred model projected 2021-2040 trends. Globally, ASYR fell from 58.088 to 38.718 per 100,000 (AAPC = -1.297%, P < 0.001), with high-SDI countries seeing a 54.0% reduction (AAPC = -2.486%) versus 32.8% in low-SDI regions. Paradoxically, low-SDI YLDs rose by 39.7%. In 2021, ASYR peaked in 15-19-year-olds at 39.906 (males) and 41.146 (females). South Asia, led by India (119.30 per 100,000), remained a high-burden hotspot. SDI correlated negatively with ASYR (ρ = -0.76, P < 0.001), with projections showing global YLDs declining to 863,352 person-years by 2040 (ASYR = 33.057).

CONCLUSION: While global progress has been made in reducing lead exposure-induced IDD, South Asia and low-SDI nations bear persistently high burdens. Strengthened international collaboration and targeted lead reduction policies are critical to advancing health equity for young people.

WHAT IS KNOWN: • Trend of the global disease burden of IDD attributed to lead exposure in the total population from 1990 to 2019.

WHAT IS NEW: • Trend of the global disease burden of IDD attributed to lead exposure in children and adolescents from 1990 to 2021, with projections up to 2040.

PMID:40913158 | DOI:10.1007/s00431-025-06433-w

Support Care Cancer. 2025 Sep 6;33(10):836. doi: 10.1007/s00520-025-09886-9.

ABSTRACT

OBJECTIVE: This study examines the effects of preoperative oral carbohydrates on the perioperative period of Fibula Free Flap surgery in oral cancer patients, aiming to enhance postoperative recovery.

METHODS: The study involved 89 patients who underwent fibula flap reconstruction surgery from January to December 2023. Patients were divided into control and experimental groups based on admission time. The control group followed standard fasting guidelines, while the experimental group received 800 mL and 200 mL of carbohydrates solution orally at 10 and 2 h pre-surgery, respectively. Data collected for both groups included comfort levels, blood glucose, surgical duration, intraoperative blood loss, fluid replacement, albumin, prealbumin, hemoglobin, PCT, IL-6, flap crisis, wound infection, bleeding, thrombosis, gastrointestinal reactions, extubation time, hospital stay, and total cost. All data were statistically analyzed.

RESULTS: The experimental group reported significantly lower thirst and hunger one hour pre-surgery (p < 0.0001) and had lower blood glucose levels one day post-surgery (p = 0.0003) compared to the control group. No significant differences were observed in other preoperative or postoperative measures.

CONCLUSIONS: Preoperative oral carbohydrates improve comfort and stabilize blood glucose levels in patients undergoing oral cancer fibula flap surgery, positively influencing perioperative management. This approach is beneficial for patients receiving this type of surgery.

PMID:40913154 | DOI:10.1007/s00520-025-09886-9