Nevin Manimala

Eur J Pediatr. 2025 Jul 18;184(8):489. doi: 10.1007/s00431-025-06313-3.

ABSTRACT

Serial lung recruitment assessment in neonates with moderate-to-severe neonatal acute respiratory distress syndrome (NARDS) is crucial. However, current methods involve ionizing radiation or invasiveness, which limits their serial use in neonates. This study evaluated the feasibility of rib-indexed quantitative lung ultrasound (LUS) as a radiation-free alternative for monitoring lung aeration in neonates with moderate-to-severe NARDS on surfactant therapy combined with prone position. A prospective observational study enrolled 35 term neonates with moderate-to-severe NARDS. Lung recruitment was assessed via anterior-posterior approach rib-indexed quantitative LUS and posteroanterior chest X-ray (CXR) before and 6 h after combined surfactant therapy and prone position. Following the intervention, it demonstrated a significant reduction in the LUS aeration score, from a pre-intervention median of 18 points (IQR 16, 22) to a post-intervention median of 15 points (IQR 12, 20) (P < 0.001). In contrast, the decrease in the CXR score (pre-intervention median 3 (IQR 3, 4) vs. post-intervention median 2 (IQR 2, 3)) did not reach statistical significance (P = 0.059). Posterior approach rib-indexed quantitative LUS showed high concordance with posteroanterior CXR in determining the rib level of the pulmonary-diaphragmatic interface (ICC > 0.95, kappa > 0.94, P < 0.001). No adverse events occurred during the LUS assessments.Conclusion: Posterior approach rib-indexed quantitative LUS is a reliable and non-invasive modality for real-time lung recruitment assessment in neonates with NARDS. It significantly detected improved lung aeration following surfactant therapy combined with prone position, whereas CXR failed to demonstrate a statistically significant improvement. Posterior approach rib-indexed quantitative LUS can also determine the rib level of the pulmonary-diaphragmatic interface, similarly to posteroanterior CXR. The superior sensitivity and safety of rib-indexed quantitative LUS offer a clinically valuable and innovative alternative for dynamic monitoring of lung recruitment in neonatal critical care. Future multi-centre studies should integrate CT validation to confirm broader applicability.Trial registration: The trial was prospectively registered with the Chinese Clinical Trial Registry (ChiCTR2300074652) on August 11, 2023.

PMID:40679694 | DOI:10.1007/s00431-025-06313-3

Trop Anim Health Prod. 2025 Jul 18;57(7):304. doi: 10.1007/s11250-025-04553-x.

NO ABSTRACT

PMID:40679686 | DOI:10.1007/s11250-025-04553-x

J Robot Surg. 2025 Jul 18;19(1):403. doi: 10.1007/s11701-025-02557-1.

ABSTRACT

Robotic surgery is increasingly prevalent in thoracic surgery. Studies of specific kinematic data on outcomes are missing. The object of this study was to examine correlations between years in practice, robotic experience, and kinematic (motion) data on complications and readmissions. Kinematic data from the first lymph node dissection of anatomic robotic lung resections were combined with data from a prospectively maintained single institution database. Kinematic data included arm movement speed, economy of motion, and camera movement. Lobectomies and segmentectomies were matched and propensity-score weighted with inverse-probability treatment weights. Pearson’s correlations, between years in practice, robotic experience, and kinematic data; and logistic regression; between years in practice and robotic experience on complications and readmissions were done. Lobectomies, 42, and segmentectomies, 31, from 2022 to 2023 were included. After matching, lymph nodes sampled were greater with lobectomies than segmentectomies, but other data were well matched; nodes sampled with lobes 13.4 vs 7.6 with segments, p < 0.001. Years in practice and robotic experience were not correlated with complications or readmissions. Significant correlations were noted between kinematic data and robotic experience. Length of stay had a negative correlation with robotic experience, -0.16, p < 0.001. No odds ratios were significant. In this small series, decreased length of stay was correlated with increased robotic experience which was a stronger outcome determinant than practice years. The complications and readmissions were not correlated with either measure. Increasing robotic experience may help optimize patient care but additional data are needed to establish usefulness of specific kinematic data.

PMID:40679677 | DOI:10.1007/s11701-025-02557-1

Sleep Breath. 2025 Jul 18;29(4):247. doi: 10.1007/s11325-025-03378-0.

ABSTRACT

PURPOSE: The relationship between obesity hypoventilation syndrome (OHS) and traffic accidents has not been previously studied. We aimed to determine the frequency of traffic accidents and the associated risk factors among people with OHS and compare with obstructive sleep apnoea (OSA) individuals.

METHODS: We screened patients diagnosed with OSA and/or OHS in our sleep laboratory between 2015 and 2023. Patients who had a driver’s license, had been driving for at least five years, at least three days a week, and drove more than 5000 km/year and had not received positive airway pressure treatment prior to their diagnosis were included. Polysomnographic data, the Epworth Sleepiness Scale (ESS), the Berlin Sleep Questionnaire were collected from the records. The Fatigue Assessment Scale (FAS) and inattention scores before the diagnosis, driving information and accident numbers from the three years before the diagnosis to the phone call were evaluated.

RESULTS: A total of 121 patients (OHS/OSA: 43/78, F/M: 5/116, age: 46.9 ± 9.7 years, body mass index [BMI]: 32.5 ± 5.7 kg/m²) were included. ESS, FAS, apnoea-hypopnea index (AHI), oxygen desaturation index (ODI) and percentage of total sleep time with SpO₂ less than 90% were significantly greater in OHS patients (p = 0.012, p = 0.028, p = 0.003, p = 0.002 and p = 0.021, respectively). The frequency of accidents was greater in OHS patients than in OSA patients (46.5% vs. 26.9%, p = 0.029). In the multivariate analysis, only BMI was an independent factor (OR: 1.185, 95% CI: 1.005-1.396, p = 0.044).

CONCLUSION: Traffic accidents were more common in OHS patients than in OSA patients, with obesity as the primary independent risk factor.

PMID:40679659 | DOI:10.1007/s11325-025-03378-0

Food Funct. 2025 Jul 18. doi: 10.1039/d5fo00873e. Online ahead of print.

ABSTRACT

The rising prevalence of type 2 diabetes (T2D) demands effective dietary strategies. High-phenolic extra virgin olive oil (EVOO) has been proposed as a functional food with antidiabetic properties. This study evaluates the effects of a high-phenolic EVOO from native Galician olives on glycemic control (primary outcome), lipid profile, anthropometric and blood pressure parameters (secondary outcomes) in adults with T2D. A 24-week experimental, prospective, randomized, parallel, long-term controlled trial was conducted with 116 T2D subjects. Participants were randomly allocated either to a Control group advised to minimize consumption of EVOO (preferring refined olive oil blends) or an Interventional group receiving 30 mL day^-1 of Galician phenolic-rich EVOO. Glycemic biomarkers, lipid profile, anthropometric indices, and blood pressure were assessed at baseline, 12 and 24 weeks. After 24 weeks, the Interventional group demonstrated significant reductions in insulin resistance (HOMA IR). No significant changes were observed in lipid profile or blood pressure in either group, while both groups exhibited modest reductions in body weight and body mass index (BMI). Although beneficial effects were particularly pronounced among individuals with obesity (reductions in fasting glucose, estimated average glucose and glycosylated hemoglobin (HbA1c)) and insulin-resistant participants (reductions in fasting insulin and HOMA IR), these subgroup analyses lacked sufficient statistical power and must be interpreted cautiously. These findings highlight the therapeutic potential of phenolic-rich EVOOs as a complementary dietary strategy for managing T2D.

PMID:40678895 | DOI:10.1039/d5fo00873e

Int Nurs Rev. 2025 Sep;72(3):e70071. doi: 10.1111/inr.70071.

ABSTRACT

AIMS: This study explores how workplace violence influences community nurses’ job burnout, specifically identifying the chain-mediating role of perceived stress and job satisfaction in this relationship.

BACKGROUND: Existing research highlights the negative impacts of workplace violence on nurses’ physical health, mental well-being, and job attitudes. However, community nurses remain understudied, particularly regarding the sequential mediating roles of perceived stress and job satisfaction between workplace violence and burnout.

METHODS: This cross-sectional study followed STROBE guidelines and recruited 814 community nurses from 75 communities in southwest China. Data were collected via Questionnaire Star using five validated instruments to assess job burnout, job satisfaction, workplace violence exposure, and perceived stress. Descriptive statistics and Pearson’s correlations were analyzed using SPSS 26.0, while structural equation modeling tested the chain-mediating effects of perceived stress and job satisfaction in the workplace violence-burnout relationship among community nurses.

RESULTS: Workplace violence was positively correlated with job burnout. Perceived stress and job satisfaction partially mediated this relationship and functioned as sequential mediators in the violence-burnout pathway.

CONCLUSION: Workplace violence exacerbates community nurses’ job burnout through a chain-mediating pathway involving elevated perceived stress and subsequent diminished job satisfaction.

IMPLICATIONS FOR NURSING AND NURSING POLICY: Managers should prioritize workplace violence against community nurses by enhancing violence prevention training to improve staff’s risk assessment and emergency response skills. Additionally, standardized violence reporting systems, trauma assessment protocols, workplace environment improvements, and psychological support mechanisms should be established to create a comprehensive prevention-response framework.

PMID:40678877 | DOI:10.1111/inr.70071

Int Nurs Rev. 2025 Sep;72(3):e70067. doi: 10.1111/inr.70067.

ABSTRACT

AIMS: To assess home disaster preparedness levels of individuals with sickle cell disease to determine education and resource needs and inform policy. To evaluate the association between healthcare provider discussion of preparedness and level of preparedness.

BACKGROUND: Research demonstrates that extreme weather events and public health emergencies result in increased hospital visits for people with sickle cell disease, yet little is known about home disaster preparedness knowledge and actions of these individuals.

METHODS: Cross-sectional study of US adults diagnosed with sickle cell disease. The independent variable was the healthcare provider discussion of household disaster preparedness. The dependent variable was the Household Emergency Preparedness Instrument’s General Preparedness score. Participants self-reported their preparedness actions and disaster supplies through an online survey. Descriptive statistics were analyzed, along with a Welch t test, to examine the associations between the study variables. This study was reported according to the STROBE checklist.

RESULTS: The average General Preparedness score of this sample (N = 32) indicated that the majority of participants were not considered well prepared for disasters. Higher scores were found among participants who had discussions with their healthcare providers about how to prepare for disasters.

DISCUSSION: The sample’s average General Preparedness score was higher than other patient populations assessed with this instrument, possibly due to routine discussions about medical emergency preparedness that individuals with sickle cell disease receive from healthcare providers.

CONCLUSION: Home disaster preparedness levels should be improved to decrease disaster-related morbidity and mortality.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nurses should develop or advocate for home disaster preparedness lessons, community interventions, and public policies to meet the unique needs of community members with sickle cell disease before, during, and after disasters.

PMID:40678875 | DOI:10.1111/inr.70067

Clin Pharmacol Ther. 2025 Jul 18. doi: 10.1002/cpt.70006. Online ahead of print.

ABSTRACT

This study assessed the use of 35 pharmacogenomic (PGx) medications listed in the Royal College of Pathologists of Australasia (RCPA) guideline, estimated the potential costs of subsidizing PGx testing in Australia, and predicted related prescribing changes. Using administrative claims data from the Pharmaceutical Benefits Scheme, accessed via the Australian Bureau of Statistics DataLab, we identified individuals who received any of the 35 medications between January 2021 and December 2023. Incident prescribing rates were calculated for children (0-17), adults (18-64), and older adults (65+). Adults (14.91%) and older adults (14.44%) had the highest rates of PGx medication use, followed by children (3.53%). Commonly prescribed medications included proton pump inhibitors, with frequent associations to genes such as CYP2C19 across all age groups. Estimated costs of PGx testing, assuming 50% and 75% population uptake, were highest for older adults: AUD$1.95 million and AUD$2.93 million, respectively. Predicted prescribing changes, based on literature-reported phenotype frequencies by ancestry, suggested that up to 18.58% of individuals using drugs like clopidogrel or voriconazole may need alternative treatments due to poor metabolism. These findings highlight the clinical potential of integrating PGx testing into routine practice, especially for medications included in international pharmacogenomic guidelines. While implementation would entail significant upfront costs, PGx testing could enhance medication safety and effectiveness and health care cost-efficiency. Future research should focus on scalable strategies for PGx implementation across diverse health care settings to optimize patient care globally.

PMID:40678859 | DOI:10.1002/cpt.70006

Ann Hum Genet. 2025 Jul 17:e70004. doi: 10.1111/ahg.70004. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) predominantly affects older women, with research suggesting elevated follicle-stimulating hormone (FSH) levels in postmenopausal women correlate with AD risk and cognitive decline. Understanding the causal relationship between FSH and AD is essential.

MATERIALS AND METHODS: We selected single-nucleotide polymorphisms (SNPs) linked to FSH as instrumental variables (IVs) for Mendelian randomization (MR). Statistical methods, including inverse variance weighted (IVW), MR Egger, Weighted Median, Weighted Mode, and Simple Mode, were employed to assess causality and potential pleiotropy. Shared genetic loci between FSH and AD were explored.

RESULTS: We carefully identified and utilized a total of 20 valid SNPs as IVs to assess the potential causal relationship between FSH and AD. Our analysis revealed a significant causal association between genetically determined FSH levels and AD [beta = -0.004; OR = 0.996, 95% confident interval (CI): 0.994-0.999; p = 0.002]. We successfully identified 20 SNPs that correspond to 8 differentially expressed genes (DEGs) between AD and non-demented (ND). These genes have not been previously reported to be linked to either FSH or AD. We conducted an in-depth analysis to explore the potential roles of these genes in the context of FSH and AD.

CONCLUSION: Our MR study revealed that FSH potentially has a causal association with AD. Additionally, FSH might possess distinctive biological mechanisms that influence the development of AD.

PMID:40678826 | DOI:10.1111/ahg.70004

Ther Adv Musculoskelet Dis. 2025 Jul 16;17:1759720X251350087. doi: 10.1177/1759720X251350087. eCollection 2025.

ABSTRACT

BACKGROUND: Treating rheumatic musculoskeletal diseases (RMDs) during pregnancy and breastfeeding presents significant complexities, mainly due to inconsistencies between the clinical guidance documents and the reference safety information, including the summary of product characteristics (SmPC) and the patient information leaflets (PIL).

OBJECTIVES: To assess healthcare professionals’ (HCPs) prescribing behaviors, comfort levels, and challenges when advising patients, focusing on discrepancies between clinical guidance documents and SmPC/PIL.

DESIGN: Online survey entitled PRAISE (Perception of healthcare providers Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives) and disseminated through HCPs groups and social media.

METHODS: A cross-sectional survey was conducted among 414 HCPs globally. Respondents were divided into prescribers (n = 336) and non-prescribers (n = 78) based on their self-reported role in prescribing antirheumatic medications to pregnant or breastfeeding patients with RMDs. The survey covered demographics, clinical experience, confidence in prescribing, use of clinical guidelines, and experiences managing conflicting information between guidelines and SmPC/PIL.

RESULTS: Prescribers were more likely than non-prescribers to feel comfortable discussing medication safety during pregnancy. Most prescribers found clinical guidance documents useful, with 48% rating them as “very useful” and 38% as “extremely useful.” In case of conflicting information between clinical guidance documents and SmPC/PIL, 58% of HCPs reported that it caused confusion and tension in patient-doctor relationships, and almost 20% of them are “likely” or “very likely” to discontinue ongoing treatment. Clear communication and shared decision-making were the most common strategies used to address patient concerns.

CONCLUSION: HCPs often face significant challenges when advising patients with RMDs on the use of medications during pregnancy and breastfeeding. Conflicting information between clinical guidance documents and SmPC/PIL can disrupt patient-doctor relationship and lead to treatment discontinuation, with potential consequences on maternal disease control. Improved alignment between clinical guidance documents and the SmPC/PIL could enhance patient care and prevent confusion among HCPs and patients.

PMID:40678818 | PMC:PMC12267951 | DOI:10.1177/1759720X251350087