Tag: nevin manimala

J Neonatal Perinatal Med. 2025 Apr 29:19345798251339650. doi: 10.1177/19345798251339650. Online ahead of print.

ABSTRACT

IntroductionInfants born less than 32-week gestation are at increased risk of respiratory distress syndrome due to underdeveloped pulmonary alveoli. Despite known respiratory benefits associated with positive end expiratory pressure (PEEP), our staff expressed concern that prolonged exposure to PEEP would contribute to increased risk of pneumothorax and delayed initiation of oral feeding.​ This quality improvement project aimed to standardize PEEP use with a guideline for early initiation, continuation, and subsequent discontinuation in infants born at less than 32-week gestation.MethodsWe developed and implemented a “Keep the PEEP” guideline, which included recommendations for initiation of PEEP at delivery, continuation through 32-week post-menstrual age (PMA), and discontinuation. Data collection occurred between July 2019-July 2021 (pre-intervention) and July 2021-August 2023 (post-intervention). Data analysis included run charts for monthly compliance, and bivariate analysis of pre- and post-intervention data. Interventions included team member education and team engagement through auditing.ResultsWe achieved a median compliance of 100% with PEEP use through 32-week PMA. We found no statistically significant differences in a pre- versus post-intervention comparison of pneumothorax incidence [14 versus 13, p = 0.86], bronchopulmonary dysplasia (BPD) incidence [82 versus 68, p = 0.65], median post-menstrual age at first oral feed [34.1 versus 34.1, p = 0.56], or median length of stay [55 versus 43, p = 0.2].ConclusionsWe successfully implemented a new respiratory guideline to standardize PEEP use in our unit during the study period. Despite initial concerns, the incidence of pneumothorax and the median gestational age at initiation of oral feedings remained unchanged.

PMID:40297950 | DOI:10.1177/19345798251339650

Facts Views Vis Obgyn. 2025 Mar 28;17(1):61-67. doi: 10.52054/FVVO.2024.13453.

ABSTRACT

BACKGROUND: Various surgical techniques for the treatment of colorectal endometriosis have been described, and the benefit of a preventive stoma remains unclear.

OBJECTIVES: The aim of our study is to evaluate the risk of complications in patients who underwent surgery for colorectal endometriosis without a policy of preventive stoma.

METHODS: Retrospective cohort study of 97 consecutive patients treated for colorectal endometriosis in an expert centre from January 2022 to January 2024.

MAIN OUTCOME MEASURES: Complications after colorectal endometriosis surgery in patients without preventive stoma.

RESULTS: Forty-three patients were managed by segmental resection, 20 patients by single-disc excision, 5 patients by double-disc excision and 29 patients by rectal shaving. 48 patients required vaginal suturing. We found complications in 14% of patients. Severe complications (Clavien-Dindo ≥3) were encountered in 8.24% of patients. 3.09% developed a rectovaginal fistula. Patients with a colorectal endometriosis nodule larger than 3 cm had more complications than patients with smaller nodules (57.1% vs. 42.9% of total complications), with a P-value close to the statistical significance.

CONCLUSIONS: Surgery for colorectal endometriosis performed in high-volume centres by expert surgeons leads to a reduction in the risk of postoperative complications. In our study, we did not perform routine preventive stoma formation, and we did not find an increase in postoperative complications compared to the literature.

WHAT IS NEW?: This study provides data on the risk of postoperative complications in patients undergoing surgery for colorectal endometriosis without a preventive stoma policy.

PMID:40297948 | DOI:10.52054/FVVO.2024.13453

Biometrics. 2025 Apr 2;81(2):ujaf045. doi: 10.1093/biomtc/ujaf045.

ABSTRACT

Confounding and exposure measurement error can introduce bias when drawing inference about the marginal effect of an exposure on an outcome of interest. While there are broad methodologies for addressing each source of bias individually, confounding and exposure measurement error frequently co-occur, and there is a need for methods that address them simultaneously. In this paper, corrected score methods are derived under classical additive measurement error to draw inference about marginal exposure effects using only measured variables. Three estimators are proposed based on g-formula, inverse probability weighting, and doubly-robust estimation techniques. The estimators are shown to be consistent and asymptotically normal, and the doubly-robust estimator is shown to exhibit its namesake property. The methods, which are implemented in the R package mismex, perform well in finite samples under both confounding and measurement error as demonstrated by simulation studies. The proposed doubly-robust estimator is applied to study the effects of two biomarkers on HIV-1 infection using data from the HVTN 505 preventative vaccine trial.

PMID:40297938 | DOI:10.1093/biomtc/ujaf045

Clin Oral Implants Res. 2025 Apr 29. doi: 10.1111/clr.14443. Online ahead of print.

ABSTRACT

OBJECTIVES: This study compares the cumulative survival and technical complications of screw-retained implant-supported lithium disilicate crowns (SICs) on polyether ketone ketone (PEKK) base abutments and zirconia implants with those of titanium base abutments and titanium implants.

MATERIALS AND METHODS: Sixty participants were randomly and evenly assigned to receive zirconia or titanium implants. Survival and technical complications were assessed at 6 weeks after crown placement (baseline) up to 36 months. The cumulative survival of the SICs was analysed as a non-inferiority design, assuming that the difference between the titanium group and the zirconia group is not more than 10%. Technical complications were assessed based on modified USPHS criteria and Pink Aesthetic Score (PES).

RESULTS: In the zirconia group, three early implant failures occurred; all of them were successfully revised. After baseline, three implants in the zirconia group were lost due to insufficient osseointegration, and therefore the SICs have to be categorised as failures even though none of the SICs failed. The non-inferiority of the zirconia group could not be confirmed, as the cumulative survival was 10.7% lower compared to the titanium group (100%). The technical complication rate was low, with no statistically significant difference between the groups. The PESs improved significantly compared to baseline, with no significant difference between the groups at 12 months.

CONCLUSION: Hybrid abutment SICs with PEKK base abutments on two-piece zirconia implants could be an alternative to hybrid abutments SICs with titanium base on titanium implants. However, the lower osseointegration rate of the zirconia implants has to be considered.

TRIAL REGISTRATION: This study was registered in the German Clinical Trial Register (Deutsches Register Klinischer Studien) (number: DRKS00014866).

PMID:40297919 | DOI:10.1111/clr.14443

Med Sci Law. 2025 Apr 29:258024251328790. doi: 10.1177/00258024251328790. Online ahead of print.

ABSTRACT

The recent Julian Assange case raised a number of important issues regarding the role of expert witnesses in court. While written from a personal perspective, this paper will suggest that these issues need much fuller discussion than they have received to date. They will be discussed in the context of what actually happened in this case, the details of which were reported only sketchily (and sometimes inaccurately) in the press. First, there is the question of what is properly a medical or a legal responsibility. A second issue concerns whether re-litigation of already determined matters should be permitted in higher courts, when the expert does not have the opportunity to respond. A third matter involves the apparently differing professional views and ethos of the legal and other professions regarding matters of personal privacy for non-participants, particularly with respect to the safeguarding of children. Other issues include the language which may be used by some lawyers in criticising expert testimony, the protection of experts from potentially libellous reporting in the press, and the use and abuse of diagnostic classifications, such as the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM). These various matters have implications for larger concerns regarding the recruitment of suitable expert witnesses to the courts.

PMID:40297917 | DOI:10.1177/00258024251328790

Acta Crystallogr D Struct Biol. 2025 May 1. doi: 10.1107/S2059798325002852. Online ahead of print.

ABSTRACT

Serial crystallography is an important technique with unique abilities to resolve enzymatic transition states, minimize radiation damage to sensitive metalloenzymes and perform de novo structure determination from micrometre-sized crystals. This technique requires the merging of data from thousands of crystals, making manual identification of errant crystals unfeasible. cctbx.xfel.merge uses filtering to remove problematic data. However, this process is imperfect, and data reduction must be robust to outliers. We add robustness to cctbx.xfel.merge at the step of uncertainty determination for reflection intensities. This step is a critical point for robustness because it is the first step where the data sets are considered as a whole, as opposed to individual lattices. Robustness is conferred by reformulating the error-calibration procedure to have fewer and less stringent statistical assumptions and incorporating the ability to down-weight low-quality lattices. We then apply this method to five macromolecular XFEL data sets and observe the improvements to each. The appropriateness of the intensity uncertainties is demonstrated through internal consistency. This is performed through theoretical CC_1/2 and I/σ relationships and by weighted second moments, which use Wilson’s prior to connect intensity uncertainties with their expected distribution. This work presents new mathematical tools to analyze intensity statistics and demonstrates their effectiveness through the often underappreciated process of uncertainty analysis.

PMID:40297896 | DOI:10.1107/S2059798325002852

Work. 2025 Mar;80(3):1137-1143. doi: 10.1177/10519815241289654. Epub 2024 Oct 21.

ABSTRACT

BackgroundWork-related stressors are a significant predictor of long-term sickness absence due to mental disorders (LTSA-MD) issues.ObjectiveTo examine the relationship between work-related stressors and LTSA-MD among Japanese public servants.MethodsA retrospective cohort study design was utilized, analyzing data from public servants in City A, Japan, who underwent mandatory annual stress checks from 2011 to 2020. The study focused on LTSA-MD instances lasting over three months due to mental disorders. The Brief Job Stress Questionnaire (BJSQ) was employed to measure occupational stress factors. Cox Hazard Models adjusted for demographic and occupational variables were used to examine the relationship between BJSQ sub-items and the onset of LTSA-MD.ResultsAmong the 1026 LTSA-MD instances identified, an association was found between the scores of job stressors, stress responses, and job satisfaction of BJSQ with increased LTSA-MD risk, whereas social occupational support was not related.ConclusionsThe findings highlight the critical role of occupational stress, stress response, and job satisfaction in predicting LTSA-MD among Japanese public servants. Mitigating these factors could significantly reduce the risk of LTSA-MD, underscoring the importance of implementing targeted workplace interventions.

PMID:40297888 | DOI:10.1177/10519815241289654

Work. 2025 Mar;80(3):1066-1075. doi: 10.1177/10519815241289697. Epub 2024 Nov 25.

ABSTRACT

BackgroundWhile safety climate and performance are extensively studied, few research studies have explored the relationship between safety climate and both retrospective and prospective indicators of safety performance.ObjectiveThis study aims to investigate the relationships between safety climate, safety behavior, musculoskeletal disorder (MSD) symptoms, and injury experience in manufacturing using structural equation modeling (SEM).MethodsThe study enrolled 409 employees from 15 manufacturing companies in Urmia, Iran in 2021. Data were collected using safety climate, safety behavior, and Nordic musculoskeletal disorders questionnaires. Occupational injury experiences from the past year were also recorded. SEM was used to analyze safety climate’s relationships with performance variables.ResultsA positive relationship was observed between safety climate and safety behavior (r = 0.38, p < 0.01). Symptoms of MSD correlated significantly with safety climate (r = -0.12, p < 0.05) and injury experience (r = 0.10, p < 0.05). A significant association was found between safety climate and safety behavior factors in the first model (ß = 0.19, p = 0.001). The overall fit indices for the proposed model were acceptable. SEM confirmed a significant association between safety climate and safety behavior (ß = 0.20, p = 0.001). However, no relationship was found between safety climate/behavior and injury experience or MSD symptoms.ConclusionsThe safety climate influenced safety behavior but had no effect on employees’ self-reported injuries or MSD symptoms. Enhancing workplaces safety climate could prevent unsafe behaviors. This study recommends exploring the association between safety climate and safety performance indicators, considering potential mediators and moderators.

PMID:40297885 | DOI:10.1177/10519815241289697

Work. 2025 Mar;80(3):1254-1264. doi: 10.1177/10519815241289718. Epub 2024 Nov 29.

ABSTRACT

BackgroundStudies show contradictory results on telework and MSDs, recommending investigating ergonomic factors and considering mental workload and inactivity.ObjectiveTo analyze the predictive association of mental workload, postural overload, and physical inactivity on the presence of MSDs in university professors in a pandemic context.MethodsA pilot cross-sectional study. An online self-administered questionnaire was used with the Nordic Musculoskeletal Questionnaire (NMQ) to assess MSDs, the NASA-Task Load Index (NASA-TLX) for mental workload, The Rapid Office Strain Assessment (ROSA) to quantify ergonomic risks, and a physical activity question. The data obtained were analyzed by descriptive statistics and the association between the independent and dependent variables by Chi-square and logistic regression with an α = 0.05.ResultsFifty-one university professors (58.8% female) participated. The frequency of MSDs was 82.3% and was most common in the neck region (62.7%). Significant associations of mental workload, postural overload, and physical inactivity on MSDs were found. Multiple predictive associations were observed between MSDs in the wrists and hands, chair postural overload, and physical inactivity (OR = 11.84 and OR = 15.38, respectively) while considering confounding variables such as gender, age, and BMI. In addition, MSDs in the upper back were observed with chair and mouse-keyboard postural overload (OR = 5.60 and OR = 7.59, respectively).ConclusionsPredictive associations exist between mental workload, postural overload, physical inactivity, and MSDs. In the post-COVID era, teleworking has become essential in universities, and it is crucial to plan for it to prevent the risk of musculoskeletal disorders.

PMID:40297884 | DOI:10.1177/10519815241289718

Work. 2025 Mar;80(3):1040-1052. doi: 10.1177/10519815241290000. Epub 2024 Nov 27.

ABSTRACT

BackgroundThe recurrent incompatibility between manual tools and human users is a drawback normally associated with the physical capacity of the worker. Hence, the conception and design of comfortable tools should consider the user experience.ObjectiveThis work looks forward to identifying key descriptors influencing the comfort experience, through the usage assessment of a by-pass-type manual cutting tool (pruning scissors).MethodsThis was a cross-sectional research which was carried out in three stages: (i) Identification of the relevant descriptors using a documented review, (ii) Identification of the relevant descriptors through the user experience, which is documented using semi-structured interviews (n = 20), and (iii) Evaluation and grading of the identified descriptors through interviews and the semantic-differential-methodology application (n = 50).ResultsData were evaluated using descriptive-statistics tools, which allowed us to identify comfort descriptors not included in the literature. Similarly, data were treated using the principal component analysis technique (PCA).ConclusionsIt was found that comfort and discomfort behave like two opposites on a continuum scale and that perception changes according to the tool and the specific task in which the user is immersed. On the other hand, it was figured out that tool appearance or aesthetics are not related to comfort.

PMID:40297881 | DOI:10.1177/10519815241290000