Nevin Manimala

Cureus. 2025 Jul 26;17(7):e88818. doi: 10.7759/cureus.88818. eCollection 2025 Jul.

ABSTRACT

Introduction Personal statements (PSs) have long been part of the Electronic Residency Application Service (ERAS) application; however, there exist only limited guidelines for their creation and even fewer for their role in the application review process. Applicants invest significant time in writing their PSs, and still, program directors rank PSs among the least important factors in interview and rank order list decisions. The emergence of generative artificial intelligence (AI), particularly large language models (LLMs) like ChatGPT, has introduced questions of ethics and originality across all aspects of education, particularly in the generation of free-form documents such as the PS. This study evaluates whether AI-generated PSs are distinguishable from authentic ones written by applicants and their perceived impact on residency selection. Methods Five AI-generated PSs were created using ChatGPT, incorporating applicant location, hobbies, and career background. Five de-identified, authentic PSs randomly selected from incoming emergency medicine (EM) interns were used for comparison. A Qualtrics survey was distributed electronically to the Council of Residency Directors (CORD) community. Respondents rated the PSs on writing quality, ability to convey personal attributes, and perceived influence on interview decisions. Statistical analyses (ANOVA and Wilcoxon tests) were used to assess differences between AI-generated and authentic statements. Results A total of 66 responses were collected over a two-month period. Of these, eight respondents did not regularly review ERAS applications, and 28 did not complete the survey beyond the initial question, leaving 30 responses for analysis. There were no statistically significant differences between AI-generated and authentic PSs in grammar and writing style (p = 0.5897), expression of personal attributes (p = 0.6827), overall quality (p = 0.2757), or perceived influence on interview decisions (p = 0.5457). Free-text comments reflected skepticism about the value of the PS in the selection process. Conclusion AI-generated PSs performed comparably to authentic ones, potentially further challenging the relevance of PSs in residency applications. These findings suggest an inherent lack of originality in the PS and may support re-evaluating the role of the PS and even exploring more meaningful ways to assess applicant fit in the residency selection process. Novel methods, such as structured interviews, standardized video responses, personality inventories, or situational judgment tests, may be considered to supplement the role intended for the PS.

PMID:40735658 | PMC:PMC12305746 | DOI:10.7759/cureus.88818

J Exp Orthop. 2025 Jul 29;12(3):e70332. doi: 10.1002/jeo2.70332. eCollection 2025 Jul.

ABSTRACT

PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is the most used surgical technique in the treatment of patellofemoral instability. However, the role of patient specific factors like age, sex and body mass index (BMI) at surgery is being increasingly discussed. The aim of this study was to study the influence of these factors with regards to functional outcomes and redislocation rates.

METHODS: All patients with patellofemoral instability, who were treated with isolated MPFL reconstruction surgery between 01/2017 to 01/2022, were included. Patients with pathologic risk factors, high-grade cartilage damage, prior surgeries and age <14 years were excluded. Demographic information and information concerning surgery, complications and history were collected. Patient reported outcome measures (PROMs) were collected preoperatively, after 6 and 12 months postoperatively and at final follow-up using multiple standardised scores (knee injury and osteoarthritis outcome score, International Knee Documentation Committee [IKDC], Tegner activity scale, Kujala, BANFF).

RESULTS: Of the 62 patients included in this study 42 (67.7%) were female with a mean age of 24.8 ± 7.6 years and a mean BMI of 24.5 ± 4.7 kg/m² at the time of surgery. Final follow-up was 42.3 ± 23.4 months. Fifty-four (90.3%) patients were satisfied with the functional outcome, four (6.5%) patients suffered recurrent dislocation.Overall, the functional outcome was very good in our study population (e.g., Kujala 87.0 ± 10.5, IKDC 76.4 ± 13.7). In the subgroup analysis, there were no significant differences in the functional outcome between women and men (e.g., Kujala score: 87.2 ± 11.4 vs. 86.4 ± 7.8, p = 0.81) and there was no correlation with BMI at time of surgery (e.g., Kujala, r = 0.11, p = 0.53). However, statistically significant correlations were detected in functional outcome with the age at surgery.

CONCLUSION: Older age at the time of surgery has a highly significant negative correlation with the functional outcome after isolated MPFL reconstruction. Therefore, surgeons must be highly vigilant and identify high-risk patients even before surgery and necessary MPFL reconstruction should not be delayed.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:40735637 | PMC:PMC12305113 | DOI:10.1002/jeo2.70332

Front Microbiol. 2025 Jul 15;16:1540611. doi: 10.3389/fmicb.2025.1540611. eCollection 2025.

ABSTRACT

The microorganisms are main drivers of biogeochemical processes in geothermal ecosystems. The dissimilatory nitrate-to-ammonium reduction pathway (DNRA) could act as an alternative source of ammonium and provide an important nitrogen supply for the maintenance of geothermal ecosystems. Investigating the distribution of DNRA-functional bacteria is of great significance to understanding the source of biological nitrogen production in geothermal environments. In this study, we characterized the community distribution of microorganisms harboring nrfA genes in the sediments of hot springs from the Tibet-Yunnan geothermal zone, with the use of Illumina MiSeq high-throughput sequencing of nrfA genes and R language software for statistical analysis. In the present study, the nrfA genes were successfully amplified from the hot springs with a temperature of 38°C-80°C. The nrfA-based phylogenetic analysis showed that the DNRA pathway is widespread within the geothermal ecosystems, with microorganisms harboring nrfA genes predominantly belonging to phyla Chloroflexi, Proteobacteria, Deinococcus-Thermus (top 10), etc. Genus-level analysis revealed Thermoflexus (Chloroflexi) as the dominant taxon in the DGQ, while Geothrix (Acidobacteria) showed peak abundance in weakly acidic sites. The DNRA-functional community structure and nrfA gene abundance also showed a sample variability, even among samples from the same region, there were differences in dominant populations and overall nrfA gene abundance between them. Statistical analysis results indicate that the distribution of nrfA type microorganisms was mainly influenced by physicochemical factors, including pH, SO₄ ^2-, and NO₂ ^– concentrations. These findings deepen our understanding of the nitrogen cycle in extreme environments and provide valuable perspectives on the role of nitrogen metabolism in both contemporary and ancient geothermal systems.

PMID:40735617 | PMC:PMC12303954 | DOI:10.3389/fmicb.2025.1540611

Front Pediatr. 2025 Jul 15;13:1541643. doi: 10.3389/fped.2025.1541643. eCollection 2025.

ABSTRACT

OBJECTIVES: This study aimed to investigate the clinical value of abdominal aortic spectral Doppler combined with echocardiography in the diagnosis of aortic coarctation in pediatric patients.

METHODS: Pediatric patients with aortic coarctation, diagnosed by computed tomography angiography (CTA) and surgically confirmed, were retrospectively enrolled. These patients were divided into two groups based on the availability of abdominal aortic spectral Doppler. Additionally, both abdominal aortic spectral Doppler and echocardiographic data were collected for the normal group. All data were compared and analyzed to determine the reasons for discrepancies in diagnostic results.

RESULTS: No significant differences were observed in baseline characteristics among the three groups (p > 0.05). There were statistically significant differences in aortic isthmus velocity and aortic isthmus Z-scores between the normal group and the two patient groups (p < 0.05), but there were no significant differences in aortic isthmus velocity or aortic isthmus Z-scores between the two patient groups (p > 0.05). The abdominal aortic spectral Doppler group demonstrated significantly decreased peak systolic velocity (PSV), prolonged acceleration time (AT), and reduced pulsatility index (PI) and resistance index (RI) compared with controls (p < 0.05). Echocardiographic detection rates differed between groups: non-abdominal aortic spectral Doppler group, 59 true-positive coarctation cases (sensitivity 85.5%, false-negative rate 14.5%); abdominal aortic spectral Doppler group, 75 true-positive cases (sensitivity 96.2%, false-negative rate 3.8%). The combined diagnostic model incorporating abdominal aortic PSV, AT, and aortic isthmus Z-score achieved superior performance (AUC = 0.98), significantly outperforming individual parameters.

CONCLUSIONS: Abdominal aortic spectral Doppler combined with echocardiography can improve the diagnostic sensitivity of aortic coarctation in pediatric patients and can be used as an important indirect imaging approach in clinical practice to reduce missed diagnoses of aortic coarctation.

PMID:40735604 | PMC:PMC12303967 | DOI:10.3389/fped.2025.1541643

Sci Rep. 2025 Jul 29;15(1):27589. doi: 10.1038/s41598-025-12762-5.

ABSTRACT

Genetic findings are important independent prognostic factors in childhood acute lymphoblastic leukaemia (ALL). This study presents cytogenetic data correlated with clinical factors of 1337 patients aged 1-18 years with newly diagnosed ALL treated between 2011 and 2018 under the Polish ALL IC-BFM 2009 therapeutic protocol. Overall survival (OS) for children with B-cell ALL was 95.58% at 5 years, while OS for children with T-cell ALL was 80.43% (p < 0.001). The event-free survival (EFS) rates were 86.69% and 72.92%, respectively, and the difference was also statistically significant (p < 0.001). The most common karyotypes observed were normal in 31.79% (n = 425) and high hyperdiploidy (HeH) in 18.4% (n = 246). Two aberrations were associated with a good prognosis in patients with B-cell ALL: ETV6::RUNX1 (OS = 98.47% and EFS 92.75%) and high hyperdiploidy (OS = 97.52% and EFS = 92.5%). Patients with low hyperdiploidy as well as patients with BCR::ABL1 aberration (OS = 73.05%, EFS = 73.05%) indicated a trend towards worse results (OS = 92.29%, EFS = 81.21%). Death and relapse rates were significantly higher in HeH patients without trisomy 17 and 18 compared to those with double trisomy 17 and 18 (p = 0.013). Our study advocates, cytogenetic testing remains an important tool in the diagnosis of paediatric patients with ALL IC-BFM 2009 protocol, as well as it shows that cytogenetic testing’s use for treatment stratification improved the outcome of children with ALL in Polish paediatric onco-haematology centres.

PMID:40731127 | DOI:10.1038/s41598-025-12762-5

Sci Rep. 2025 Jul 29;15(1):27680. doi: 10.1038/s41598-025-11087-7.

ABSTRACT

Geodesic cycles, or loops of nodes connected in a sequence within a network, are an important if under-studied network motif, and their prominence or deficiency is associated with both beneficial and detrimental properties in diverse kinds of networks. Here, we examine cycles formed by people’s reports of informal borrowing/lending and friendship ties among 22,551 rural Hondurans (in 174 isolated villages), and we explore their association with personal and community wealth across two time points. We find that cycles of different lengths (i.e., 3 or 4 ties in a loop) constitute an over-represented motif, and their quantity is strongly associated with individual wealth, i.e., richer individuals are involved in more cycles. Furthermore, we introduce a new metric of cycle composition, defined as the average of some measure (e.g., wealth) of a node’s alters in its cycles, and find that this metric outperforms cycle quantity as an indicator of both current and future wealth. A longitudinal analysis also reflects a higher participation rate in future cycles among wealthier individuals. When benchmarking cycles with eigenvector centrality, we find that cycle participation offers distinctive insights. Finally, cycle composition is a strong indicator of overall village wealth. In sum, the potential for the flow of money in a village through structural social network cycles may relate to both individual-level and village-level wealth.

PMID:40731117 | DOI:10.1038/s41598-025-11087-7

Hypertens Res. 2025 Jul 29. doi: 10.1038/s41440-025-02260-6. Online ahead of print.

ABSTRACT

Hypertension affects more than 4 billion people worldwide and is a major risk factor for cardiovascular disease. Improving physical activity is an effective way to manage hypertension, and there has been a lot of interest in the use of wearable devices for promoting physical activity, which have become increasingly popular in recent years, but in many countries, improvements in physical activity levels remain inadequate. This systematic review and meta-analysis investigated whether interventions using wearable devices have a beneficial effect on blood pressure in adults. Following PRISMA 2020 guidelines and registered with PROSPERO (CRD42023442506), we searched PubMed, MEDLINE, Cochrane Library, and IchuShi-Web, identifying 21 randomized controlled trials including participants with hypertension, type 2 diabetes, or overweight/obesity. Interventions ranged from 12 to 48 weeks using pedometers, activity trackers, and smartwatches. Random-effects meta-analysis showed these interventions did not produce statistically significant improvements in systolic or diastolic blood pressure at any intervention duration (12, 24, or 48 weeks). Similarly, no statistically significant improvements were found in secondary outcomes (body weight, fasting blood glucose, and Hemoglobin A1c). Heterogeneity varied from low to high depending on outcome and intervention period. These findings indicate that evidence of direct intervention using wearable devices for promoting physical activity alone is currently insufficient to establish clinically meaningful improvements in blood pressure and related metabolic parameters. Future research may need to integrate wearable technology into comprehensive care models that combine targeted feedback and education with behavioral support strategies, rather than direct intervention through monitoring alone.

PMID:40731080 | DOI:10.1038/s41440-025-02260-6

Sci Rep. 2025 Jul 29;15(1):27692. doi: 10.1038/s41598-025-98628-2.

ABSTRACT

Neonatal seizures were associated with significant rates of mortality; in which about one-third of the neonates with seizure ending up with death. Despite this, the time to death and its predictors among neonates with seizure has not been investigated; especially in Ethiopia. To determine the time to death and its predictors among neonates with seizure in public hospitals of Awi zone, Northwest Ethiopia. A multicenter prospective follow-up study was conducted in public hospitals of Awi zone on 263 neonates with seizure. Descriptive statistics, Kaplan-Meier curve, Nelson-Aalen curves, and log-rank tests were employed to describe the time to death and to assess the risk of mortality among different covariates. The Cox proportional hazards model was used to identify the predictors of time to death. AHR with 95% CI was used to identify significant predictor variables, and a statistical significance was declared at p-value < 0.05. A total of 263 neonates with seizure were followed for a total of 1334.3 person-days, and the incidence of mortality was found to be 22.5 per 1000 person-day observations (95% CI = 14.0-29.6). The median time to death was 3 days (IQR = 2-5 days). Birth trauma (AHR = 3.9, 95% CI = 1.5-10.6), neonatal sepsis (AHR = 3.4, 95% CI = 1.1-10.8), hypoglycemia (AHR = 3.2, 95% CI = 1.1-9.3), and tonic type seizure (AHR = 4.5, 95% CI = 1.3-15.6) were statistically significant predictors of early mortality in neonates with seizure. This study revealed that the incidence of in-hospital mortality among neonates with seizure to be high and the median time to death to be short; and the predictors of early mortality were identified. Early detection and appropriate management of neonates having birth trauma, sepsis, and hypoglycemia might be helpful.

PMID:40731073 | DOI:10.1038/s41598-025-98628-2

Sci Rep. 2025 Jul 29;15(1):27657. doi: 10.1038/s41598-025-13131-y.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has led to the development of numerous prognostic models for patient assessment. However, the potential utility of the predisposition, insult/infection, response, organ dysfunction (PIRO) score in evaluating COVID-19 severity and outcomes remains unexplored, presenting a gap in current research. A retrospective analysis was conducted on a cohort of 374 individuals diagnosed with COVID-19 who were admitted to the emergency department of Beijing Youan Hospital. Demographic data, treatment regimens, and seven prognostic scoring systems, including PIRO, were evaluated. To evaluate the models’ prognostic accuracy for 28-day mortality, area under the receiver operating characteristic (AUROC) analysis was employed. Comparative performance between scoring systems was quantified using the DeLong method for paired ROC curves. Of the 374 patients meeting inclusion criteria, 120 (32.1%) died within 28 day of hospitalization. Significant disparities were observed between survivors and non-survivors regarding age, laboratory parameters, and clinical scores. Analysis of patient distribution and mortality rates across different score ranges revealed a positive correlation between score magnitude and 28-day mortality. The PIRO score demonstrated superior prognostic capability, yielding an AUC of 0.898 (95% CI 0.866-0.929). The quick sequential organ failure assessment (qSOFA) score followed closely (AUC 0.882, 95% CI 0.849-0.914). Both critical illness risk score (COVID-GRAM) and national early warning score 2 (NEWS2) exhibited AUCs exceeding 0.85 (COVID-GRAM 0.854, 95% CI 0.812-0.895; NEWS2: 0.851, 95% CI 0.813-0.889). DeLong test analysis revealed statistically significant differences in AUC between PIRO and confusion, urea, respiration, systolic pressure, age ≥ 65 (CURB-65), pneumonia severity index (PSI), COVID-GRAM, rapid acute physiology score (RAPS), and NEWS2 (all p < 0.05). Analysis revealed the PIRO scoring system as a robust predictor of 28-day mortality among COVID-19 cases presenting to the emergency setting, offering potential refinement of risk stratification and clinical management strategies.

PMID:40731068 | DOI:10.1038/s41598-025-13131-y

Sci Rep. 2025 Jul 29;15(1):27540. doi: 10.1038/s41598-025-11084-w.

ABSTRACT

Flavonoids, a diverse class of polyphenolic phytochemicals, exhibit multifaceted biological activities critical to human health. This study leverages degree-based topological indices (TIs) to predict six physicochemical properties of sixty flavonoids using linear, quadratic, and logarithmic regression models. Statistical validation via correlation coefficients ([Formula: see text]), Root Means Square Error (RMSE), and Mean Absolute Error (MAE) revealed robust predictive power, particularly for molar refractivity ([Formula: see text], RMSE [Formula: see text], MAE [Formula: see text]), molar volume ([Formula: see text], RMSE [Formula: see text], MAE [Formula: see text]), and enthalpy of vaporization ([Formula: see text], RMSE [Formula: see text], MAE [Formula: see text]). Quadratic models consistently outperformed linear/logarithmic approaches, indicating nonlinear relationships between TIs and properties. The methodology offers a cost-effective tool for prioritizing bioactive flavonoids in drug discovery, validated by strong agreement between predicted and experimental values for external compounds (e.g., Procyanidin B2: molar refractivity RMSE [Formula: see text]). This work bridges cheminformatics and QSPR, enabling rapid property estimation for polyphenolic systems.

PMID:40731053 | DOI:10.1038/s41598-025-11084-w