Tag: nevin manimala

Invest Ophthalmol Vis Sci. 2025 Apr 1;66(4):58. doi: 10.1167/iovs.66.4.58.

ABSTRACT

PURPOSE: To compare the impact of sodium-glucose cotransporter 2 (SGLT2) and dipeptidyl peptidase 4 (DPP-4) inhibitors on age-related macular degeneration (AMD) risk among patients with type 2 diabetes mellitus (T2DM).

METHODS: This multinational, retrospective cohort study used electronic medical records from healthcare institutions across 21 countries. Adults 50 years or older with T2DM who had a prior prescription of metformin and initiated SGLT2 or DPP-4 inhibitors from 2013 to 2023 were included. The SGLT2 and DPP-4 inhibitor groups were propensity score matched in a 1:1 ratio to balance baseline characteristics and were followed for up to 5 years to observe the occurrence of AMD. Statistical analysis was performed using the Cox proportional hazards model and Kaplan-Meier analysis.

RESULTS: Our final analysis included 20,966 T2DM patients prescribed SGLT2 inhibitors and 20,966 prescribed DPP-4 inhibitors. Compared to the DPP-4 inhibitor group, the SGLT2 inhibitor group was associated with significantly lower risks of AMD (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.58-0.85) and dry AMD (HR, 0.61; 95% CI, 0.46-0.80) but not wet AMD (HR, 0.74; 95% CI, 0.48-1.16). SGLT2 inhibitors compared with DPP-4 inhibitors were linked to a reduced risk of AMD in the White population, patients prescribed empagliflozin or dapagliflozin, and individuals with glycated hemoglobin < 8.5%, estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2, hypertension, or dyslipidemia, regardless of body mass index level.

CONCLUSIONS: In patients with T2DM, those prescribed SGLT2 inhibitors may experience lower risks of AMD and dry AMD compared to those prescribed DPP-4 inhibitors.

PMID:40257783 | DOI:10.1167/iovs.66.4.58

Invest Ophthalmol Vis Sci. 2025 Apr 1;66(4):60. doi: 10.1167/iovs.66.4.60.

ABSTRACT

PURPOSE: To analyze the clinical spectrum and natural history of MYO7A-associated Usher syndrome type I (USH1).

METHODS: Patients with molecularly confirmed MYO7A-associated USH1 in a single tertiary referral center. Data was extracted from physical and electronic case notes, including imaging and electrophysiology. Genetic results were reviewed, and the detected variants were assessed. Main outcome measures were clinical findings, qualitative and quantitative analysis of retinal imaging, and electrophysiology.

RESULTS: Eighty patients were identified and evaluated longitudinally. The mean age (±SD) of onset of symptoms was 12.0 ± 5.8 years of age, and a mean follow-up time of 16.2 years. BCVA was 0.4 ± 0.5 LogMAR at baseline, and 0.7 ± 0.8 LogMAR at the last visit for both eyes. The change in BCVA over time was 0.02 LogMAR per year. A hyperautofluorescent (hyperAF) ring was present in 51% of the patients. The mean ellipsoid zone width (EZW) at baseline was 2568.2 ± 1528.9 µm OD and 2527.9 ± 1609.3 µm OS, which decreased to 2012.3 ± 1705.1 µm OD and 1806.3 ± 1647.1 µm OS at last visit. Electrophysiology revealed rod and cone dysfunction with relative or complete sparing of macular function. There were statistically significant changes in BCVA, EZW, and hyperAF ring between baseline and follow-up. Genetic analysis identified 83 variants in MYO7A, including 18 novel variants.

CONCLUSIONS: Longitudinal analysis shows that the majority of patients retain central visual function and structure until the fifth decade of life, which informs advice on prognosis and the window for therapeutic intervention.

PMID:40257781 | DOI:10.1167/iovs.66.4.60

Int J Palliat Nurs. 2025 Apr 2;31(4):173-180. doi: 10.12968/ijpn.2023.0044.

ABSTRACT

BACKGROUND: Patients with cancer can have problems sleeping. One measure that can help patients with cancer to improve the quality of their sleep is the 5A Self Management Model method.

AIM: This study aimed to determine the effect of the 5A Self Management Model on the quality of sleep of patients with cancer.

METHODS: In this clinical trial, 106 patients with cancer were recruited by convenient sampling, and randomly allocated to experimental and control groups. Data collection tools were a demographic checklist and Pittsburgh Sleep Quality Questionnaire. Patients in the experimental group received a self-management programme with the 5A method for 3 months and the control group obtained the routine intervention. Data were analysed via SPSS 25 software using Wilcoxon, Mann-Whitney U, independent t-test, paired t-test and descriptive statistics.

RESULTS: Before the intervention, the mean scores of sleep quality were 13.41 (1.78) in the experimental group and 9.64 (2.45) in the control group. However, after the intervention, the mean score of sleep quality decreased in the experimental group to 5.07 (1.19) and increased by 12.81 (2.26) in the control group, significantly.

CONCLUSION: The 5A Self Management Model programme improved the quality of sleep of patients with cancer in this trial. It is recommended nurses consider this method as a part of caring for patients with cancer.

PMID:40257767 | DOI:10.12968/ijpn.2023.0044

Int J Palliat Nurs. 2025 Apr 2;31(4):195-204. doi: 10.12968/ijpn.2024.0031.

ABSTRACT

BACKGROUND: Few studies evaluate the satisfaction of patients with cancer receiving palliative care with the nursing care received.

OBJECTIVE: To evaluate satisfaction among patients with cancer in hospitalised palliative care with respect to the nursing care they received.

METHOD: This was a quantitative, descriptive-correlational and cross-sectional study that was reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. It was carried out in a university hospital in the city of Belém, Brazil. The participants were adults with cancer who were receiving palliative care and who had been hospitalised for more than 72 hours. Data collection took place between December 2022 and September 2023, and instruments were used for bedside interviews.

RESULTS: Patients receiving minimal care reported being satisfied with their nursing care in the technical-professional dimension (p=0.04).

CONCLUSION: The association between patient satisfaction and the degree of dependence is unprecedented in the scientific scenario and has the potential to motivate more in-depth studies in this area.

PMID:40257762 | DOI:10.12968/ijpn.2024.0031

JAMA Pediatr. 2025 Apr 21. doi: 10.1001/jamapediatrics.2025.0528. Online ahead of print.

NO ABSTRACT

PMID:40257760 | DOI:10.1001/jamapediatrics.2025.0528

JMIR Form Res. 2025 Apr 21;9:e68173. doi: 10.2196/68173.

ABSTRACT

BACKGROUND: Previous research has demonstrated a correlation between nursing students’ self-efficacy and their clinical performance, competence, and behavior during clinical practice placements. Assessing students’ self-efficacy in clinical performance could be a valuable method for identifying areas that need reinforcement and for recognizing students who may require additional support during clinical practice placements.

OBJECTIVE: This study aimed to translate the Self-Efficacy in Clinical Performance Scale (SECP) from English into Norwegian and to evaluate the psychometric properties of the Norwegian version.

METHODS: A cross-sectional study design was used. The SECP was translated into Norwegian following a 6-step process: forward translation, forward translation synthesis, backward translation, backward translation synthesis, cognitive debriefing, and psychometric testing. The validity and reliability of the translated version were assessed using confirmatory factor analysis (CFA), Cronbach α, McDonald ω, and composite reliability.

RESULTS: A total of 399 nursing students completed the Norwegian version of the SECP. The CFA goodness-of-fit indices (χ2/df ratio=1.578, comparative fit index=0.98, Tucker-Lewis index=0.98, standardized root mean square residual=0.056, root mean square error of approximation=0.038) indicated an acceptable model fit. Reliability measures, including Cronbach ⍺, McDonald ω, and composite reliability, were high, with factor-level values ranging from 0.94 to 0.98.

CONCLUSIONS: The Norwegian version of the SECP demonstrated strong potential as an instrument for assessing self-efficacy in both current and required competencies among nursing students in clinical practice within nursing education. Future research should aim to confirm the factor structure of the SECP and evaluate its test-retest reliability.

PMID:40257751 | DOI:10.2196/68173

Bioinformatics. 2025 Apr 21:btaf182. doi: 10.1093/bioinformatics/btaf182. Online ahead of print.

ABSTRACT

MOTIVATION: The intra-tumor heterogeneity of protein expression is well recognized and may provide important information for cancer prognosis and predicting treatment responses. Analytic methods that account for spatial heterogeneity remain methodologically complex and computationally demanding for single-cell protein expression. For many functional proteins, single-cell expressions vary independently of spatial localization in substantial proportion of the tumor tissues, and incorporation of spatial information may not affect the prognostic value of such protein biomarkers.

RESULTS: We developed a new framework for using the distributions of functional single-cell protein expression levels as cancer biomarkers. The quantile functions of single-cell expressions are used to fully capture the heterogeneity of protein expression across all cancer cells. The quantile index (QI) biomarker is defined as an integral of an unspecified function which may depend linearly or nonlinearly on a tissue-specific quantile function. Linear and nonlinear versions of QI biomarkers based on single-cell expressions of ER, Ki67, TS, and CyclinD3 were derived and evaluated as predictors of progression-free survival or high mitotic index in a large breast cancer dataset. We evaluated performance and demonstrated advantages of non-linear QI biomarkers through simulation studies.

AVAILABILITY: The associated R package Qindex is available at https://CRAN.R-project.org/package=Qindex and R package hyper.gam is available at https://github.com/tingtingzhan/hyper.gam. Examples of R code and detailed instructions could be found in vignette quantile-index-predictor (https://CRAN.R-project.org/package=hyper.gam/vignettes/applications.html#quantile-index-predictor).

SUPPLEMENTARY INFORMATION: Supplementary Material is available at Bioinformatics online.

PMID:40257750 | DOI:10.1093/bioinformatics/btaf182

J Nurs Res. 2025 Apr 22. doi: 10.1097/jnr.0000000000000672. Online ahead of print.

ABSTRACT

BACKGROUND: Children experience fear and anxiety not only during painful procedural interventions but also during painless procedural interventions such as electrocardiography (ECG). Pediatric nurses should be aware of the emotional changes experienced by children during ECG procedures.

PURPOSE: The aim of this single-center, single-blinded, randomized controlled intervention study was to investigate the impact of the undersea-themed examination table cover (UTETC) on the levels of fear and anxiety experienced by children during ECG procedures.

METHODS: This study was conducted between April 1 and July 31, 2022, in the pediatric emergency department of a training and research hospital in Turkey. The participants included 80 children (experimental group = 40, control group = 40) aged 3-12 years. The experimental group underwent the procedure in the ECG room using the UTETC, while the control group underwent the routine procedure in the examination room. The entire process was video-recorded. Video recordings were watched by two nurses who were not otherwise involved in this study, and the data were collected using the Descriptive Data Form, the Children’s Fear Scale, and the Children Emotional Manifestation Scale.

RESULTS: No statistically significant difference was found in the descriptive characteristics of the two groups (p > .05). The experimental group completed the procedure more successfully than the control group with significantly lower levels of procedure-related fear and anxiety (p < .05).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The UTETC was found to be effective in reducing fear and anxiety in children aged 3-12 years during ECG procedures in a pediatric emergency department.

PMID:40257748 | DOI:10.1097/jnr.0000000000000672

Eur J Health Econ. 2025 Apr 21. doi: 10.1007/s10198-025-01781-8. Online ahead of print.

ABSTRACT

OBJECTIVE: As European healthcare systems struggle with increasing workload and sustainability issues, it is estimated that 20% of their production is ineffective. One potential strategy to reduce this excess is by minimizing the use of unnecessary laboratory tests. The aim of this review was to investigate the effect of presenting physicians in Europe with the cost of laboratory tests at the time of ordering on the quantities and expense of laboratory tests as well as to identify knowledge gaps on this matter.

METHODS: Following PRISMA guidelines, a systematic search in PubMed and EMBASE was conducted in February 2025. Studies were included if written in English and conducted in Europe. There were no restrictions on year of publication. Study quality was evaluated using a modified Downs and Black checklist.

RESULTS: Of the 2185 publications identified, five met the inclusion criteria. All included studies were published 2002-2021 and found a reduction in order cost and/or volume of laboratory test, following price display (four with statistically significant results). The reduction in order costs were greater than the reduction in order volume. Additionally, the impact of price display diminished over time as the intervention period continued. None of the studies included patient safety measures.

CONCLUSIONS: Price display is a simple yet potentially impactful intervention as it is likely to reduce both the cost and volume of tests, thereby decreasing the workload and enhancing the sustainability of the healthcare systems. Further high-quality studies are needed to determine if price display is a patient-safe intervention.

PMID:40257741 | DOI:10.1007/s10198-025-01781-8

Sports Med. 2025 Apr 21. doi: 10.1007/s40279-025-02217-2. Online ahead of print.

ABSTRACT

BACKGROUND: In response to exercise, protein kinases and signaling networks are engaged to blunt homeostatic threats generated by acute contraction-induced increases in skeletal muscle energy and oxygen demand, as well as serving roles in the adaptive response to chronic exercise training to blunt future disruptions to homeostasis. High-intensity interval training (HIIT) is a time-efficient exercise modality that induces superior or similar health-promoting skeletal muscle and whole-body adaptations compared with prolonged, moderate-intensity continuous training (MICT). However, the skeletal muscle signaling pathways underlying HIIT’s exercise intensity-specific adaptive responses are unknown.

OBJECTIVE: We mapped human muscle kinases, substrates, and signaling pathways activated/deactivated by an acute bout of HIIT versus work-matched MICT.

METHODS: In a randomized crossover trial design (Australian New Zealand Clinical Trials Registry number ACTRN12619000819123; prospectively registered 6 June 2019), ten healthy male participants (age 25.4 ± 3.2 years; BMI 23.5 ± 1.6 kg/m²; $\dot{V}{\text{O}}_{2}max$ 37.9 ± 5.2 ml/kg/min, mean values ± SD) completed a single bout of HIIT and MICT cycling separated by ≥ 10 days and matched for total work (67.9 ± 10.2 kJ) and duration (10 min). Mass spectrometry-based phosphoproteomic analysis of muscle biopsy samples collected before, during (5 min), and immediately following (10 min) each exercise bout, to map acute temporal signaling responses to HIIT and MICT, identified and quantified 14,931 total phosphopeptides, corresponding to 8509 phosphorylation sites.

RESULTS: Bioinformatic analyses uncovered exercise intensity-specific signaling networks, including > 1000 differentially phosphorylated sites (± 1.5-fold change; adjusted P < 0.05; ≥ 3 participants) after 5 min and 10 min HIIT and/or MICT relative to rest. After 5 and 10 min, 92 and 348 sites were differentially phosphorylated by HIIT, respectively, versus MICT. Plasma lactate concentrations throughout HIIT were higher than MICT (P < 0.05), and correlation analyses identified > 3000 phosphosites significantly correlated with lactate (q < 0.05) including top functional phosphosites underlying metabolic regulation.

CONCLUSIONS: Collectively, this first global map of the work-matched HIIT versus MICT signaling networks has revealed rapid exercise intensity-specific regulation of kinases, substrates, and pathways in human skeletal muscle that may contribute to HIIT’s skeletal muscle adaptations and health-promoting effects. Preprint: The preprint version of this work is available on medRxiv, https://doi.org/10:1101/2024.07.11.24310302 .

PMID:40257739 | DOI:10.1007/s40279-025-02217-2