Tag: nevin manimala

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):426-430. doi: 10.32687/0869-866X-2026-34-s1-426-430.

ABSTRACT

This article is based on the results of a study analyzing the opinions and perceptions of medical students regarding their future professional activities. The objective of the study was to examine and analyze the attitudes and plans of medical students regarding their chosen profession. The object of the study was the professional attitudes of students in the Faculty of General Medicine. The theoretical methodology of the article is based on a sociological approach to professionalization, taking into account the activity-based and certification approaches. The empirical basis of the study was the results of a sociological survey conducted among 220 medical students in January 2026 (KSMU, Kursk, n = 100; RNRMU, Moscow, n = 75; PSPbSMU, St. Petersburg, n = 45). The study found that young people, typically those who have completed pre-professional school training, consciously choose medical universities. Half of the study participants expressed a willingness to remain in the state healthcare system, with minor regional differences. To create an effective healthcare system capable of adequately responding to the needs of young professionals, it is necessary to develop conditions for retaining young professionals in state healthcare, taking into account the expectations of todays students (unique experience, stability, career advancement, etc.).

PMID:42402105 | DOI:10.32687/0869-866X-2026-34-s1-426-430

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):358-362. doi: 10.32687/0869-866X-2026-34-s1-358-362.

ABSTRACT

Road accidents are a significant public health issue and a common cause of death. This article analyzes the main risk factors for road accidents and their impact on road mortality and injury. The most significant of these are speeding, alcohol consumption, and motorcycle use. Age, gender, and mobile phone use while driving are also significant factors. Seasonality, time of day, and road surface quality have a lesser impact on the risk of road accidents. Knowledge of road accident risk factors will enable the implementation of more effective measures to prevent road incidents. This, in turn, will reduce road user fatalities and injuries and reduce the material costs associated with the consequences of road accidents.

PMID:42402099 | DOI:10.32687/0869-866X-2026-34-s1-358-362

Ann Pharmacother. 2026 Jul 5:10600280261452547. doi: 10.1177/10600280261452547. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients, but the optimal dosing of beta-lactam antibiotics in this setting remains controversial. It is not known whether the benefit of initiating beta-lactams at normal doses outweighs the risk of accumulation and toxicity.

OBJECTIVE: We aimed to evaluate the association between early dose adjustment of piperacillin/tazobactam (PT) and 28-day intensive care unit (ICU) mortality in critically ill patients with AKI.

METHODS: We conducted a retrospective multicenter cohort study using the eICU Collaborative Research Database v2.0 and included adult ICU patients with AKI who received PT and had a pretreatment serum creatinine level corresponding to an estimated glomerular filtration rate (eGFR) <40 mL/min/1.73 m². The exposure was PT dose in the first 24 hours, which was categorized as normal (≥13.5 g/24 h) or adjusted (<13.5 g/24 h). The primary outcome was 28-day ICU mortality.

RESULTS: Among 1639 eligible patients, 224 (13.7%) received normal-dose PT and 1415 (86.3%) received adjusted doses. The overall 28-day ICU mortality was 11%, with significantly lower mortality in the normal-dose group (6.7%) compared with the adjusted-dose group (11.7%) (unadjusted odds ratio [OR] 1.85, 95% confidence interval [CI] 1.07-3.20; P = .028). After multivariable adjustment, early dose adjustment was independently associated with higher 28-day ICU mortality (adjusted OR 2.11, 95% CI 1.13-3.96; P = .020). Results were consistent across multiple subgroup and sensitivity analyses, but statistical significance was attenuated when the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used for eGFR estimation.

CONCLUSION AND RELEVANCE: Early dose adjustment of PT in critically ill patients with AKI is associated with increased 28-day ICU mortality. This finding suggests that renal dose adjustment of PT should be deferred beyond the first 24 hours of therapy in this population. Prospective studies are needed to confirm this finding, define the optimal timing of subsequent dose adjustments, and assess safety outcomes.

PMID:42402098 | DOI:10.1177/10600280261452547

Discov Nano. 2026 Jul 5;21(1):323. doi: 10.1186/s11671-026-04748-7.

ABSTRACT

The flow of blood through stenotic arteries is considered one of the most significant areas of investigation in the world of mathematical fluid mechanics. This significance arises from the topic’s application to the field of biomedicine. Within an arterial system of blood that has been stenosed, the goal of this research initiative is to investigate the effect that nanoparticles have on the characteristics that define the human circulatory system. The current investigation analyzes blood flow behavior in a controlled, permeable artery employing the Casson hybrid nanofluid model and, additionally, gold, Cu, and silver nanoparticles. The current study examines the investigation of magnetohydrodynamics (MHD) Casson hybrid nanofluid Darcy-Forchheimer flow (DFF) over a stenotic artery with a heat source/sink. By transforming the partial differential equations (PDEs) into ordinary differential equations (ODEs) by utilizing suitable similarity variables. After that, the mathematical solution of these equations used the BVP4c method in the MATLAB solver and analysis for skin and Nusselt number table values for hybrid nanofluid cases. The statistical analysis is used to solve for different physical factors. During a study in which values of both variables are subject to essentially unknown oversights, the task is utilizing statistical techniques to discover the best possible linear equations. In this concept, two different hybrid nanomaterials are used for analyzing heat transfer characteristics. According to these graphical results, the present model concludes that case-2 has better performance than case-1. Rising values of the magnetic parameter improve heat transfer owing to Joule heating impacts and control flow via the Lorentz force, which in turn affects the distribution of shear stresses close to the artery wall. The current work highlights the role of nanoparticles and magnetic fields in enhancing flexibility near arteries’ surfaces. This work has substantial repercussions for the treatment of cancer and the treatments that are used to avoid cardiovascular disease, as it suggests that improved heat transfer and shear stress distribution can enhance the effectiveness of therapies targeting tumor cells and improve blood flow in cardiovascular interventions.

PMID:42402075 | DOI:10.1186/s11671-026-04748-7

ARP Rheumatol. 2026 Apr-Jun;5(2):117-122.

ABSTRACT

BACKGROUND: The prevalence of Direct Coombs test (DCT) positivity in systemic lupus erythematosus (SLE) ranges from 12.8% to 65.2%. Approximately 5-11% of people with SLE have autoimmune haemolytic anaemia (AIHA), characterised by autoantibodies against erythrocytes that cause haemolysis. In about half of the SLE patients, DCT positivity occurs even in the absence of AIHA, likely due to immune complexes binding to red blood cells via complement receptor 1 (CR1), suggesting a higher immune complex load.

OBJECTIVES: To determine the DCT positive rate in SLE patients without AIHA and its association with disease activity, as measured by the SLE Disease Activity Index 2000 (SLEDAI-2K) score.

METHODS: This descriptive cross-sectional study was conducted at a tertiary care centre in South India from March 2023 to March 2025. SLE patients who met the 2019 ACR/EULAR classification criteria without AIHA were included. Disease activity was measured using the SLEDAI-2K. The DCT was performed using the standard antihuman globulin, and a reaction grade of 1+ or higher was considered positive. The study compared DCT-positive and DCT-negative groups using statistical analysis.

RESULTS: The study included 92 SLE patients, most of whom were female (97.8%), with a mean age of 35.1 ± 9.49 years, and a mean disease duration of 4.56 ± 4.36 years. DCT positivity without AIHA was found in 33.6% of the patients. DCT-positive patients had a higher median SLEDAI-2K score than DCT-negative patients (8 [IQR 3.5-10.5] vs 0 [IQR 0-5]; p < 0.001). DCT positivity was also strongly associated with arthritis (p < 0.001) and with higher anti-double-stranded DNA antibody levels (p = 0.008).

CONCLUSION: In individuals with SLE, DCT positivity without AIHA was common and was associated with higher contemporaneous disease activity, arthritis, and elevated anti-double-stranded DNA antibody levels. These findings suggest that DCT positivity may reflect increased immune activity at a single point in time. However, its utility in predicting future flares or monitoring longitudinal disease activity remains uncertain and requires prospective validation.

PMID:42402059

Ann Med. 2026 Dec;58(1):2696600. doi: 10.1080/07853890.2026.2696600. Epub 2026 Jul 5.

ABSTRACT

BACKGROUND: To determine the circumstances of acute poisoning cases at the Poison Control Center (2021-2024) and analyze their risk factors.

METHODS: We retrospectively analyzed the demographic characteristics, clinical features, and prognosis of patients with acute poisoning at the Poison Control Center.

RESULTS: This study included 10,402 cases comprising drug poisoning (5,074), alcohol poisoning (2,316), carbon monoxide poisoning (1,803), pesticide poisoning (882), and chemical poisoning (327). The age group with the highest incidence of poisoning was 21-40 years old (37.94%, p < 0.01). Women have a higher proportion of drug poisoning (72.59%, p < 0.01), while men have a higher proportion of alcohol poisoning (74.31%, p < 01). Patients with pesticide poisoning were predominantly educated to the middle school level or below (73.02%, p < 0.01), whereas those with alcohol poisoning were mainly educated to the high school level or above (73.88%, p < 0.01). Carbon monoxide and pesticide poisoning occur primarily in rural areas. Poisoning incidents at home accounted for 74.32%, alcohol poisoning frequently occurred in entertainment venues (60.58%, p < 0.01). Carbon monoxide poisoning is more common in January and December, whereas drug poisoning has a higher incidence throughout the year. Carbon monoxide, chemical and alcohol poisoning were predominantly accidental, whereas drug and pesticide poisoning were mainly intentional. Gastric lavage dominated pestic ide poisoning; Antidotes prevailed in alcohol poisoning.The overall mortality rate was 1.56 %, highest for pesticide poisoning (8.28%, p < 0.01).

CONCLUSION: Different types of poisoning have distinct sociodemographic characteristics, that should be considered when developing prevention and treatment policies. Personalized treatment plans should be tailored to different poisonings.

PMID:42402047 | DOI:10.1080/07853890.2026.2696600

J Pediatr Endocrinol Metab. 2026 Jul 6. doi: 10.1515/jpem-2026-0035. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the frequency of selected MKRN3 variants and to investigate genotype-phenotype associations in Uzbek children with central precocious puberty, with particular emphasis on sex-specific clinical, hormonal, and instrumental characteristics.

METHODS: This single-center study included 69 Uzbek children with CPP and 30 healthy controls (used primarily for assay validation). Targeted genotyping of three MKRN3 variants (c.1034G>A [p.Arg345His], c.1229G>A [p.Cys410Ter], and c.331G>T [p.Glu111Ter]) was performed using real-time PCR with TaqMan assays. Clinical, hormonal, skeletal, and ultrasonographic parameters were analyzed using non-parametric methods.

RESULTS: Selected MKRN3 variants were identified in 21.7 % (15/69) of this cohort of Uzbek children with CPP. The most frequent variant was c.1034G>A (13.0 %), followed by c.1229G>A (8.7 %); c.331G>T was not detected. Variant frequency was higher in boys (28.6 %) than in girls (18.7 %), without statistical significance. In girls, variant carriers had significantly smaller uterine and ovarian dimensions, larger dominant follicle diameter, and lower basal LH levels, while bone age advancement and estradiol levels were comparable. In boys, variant carriers demonstrated higher testosterone levels, with no significant differences in gonadotropins, bone age advancement, or testicular volume.

CONCLUSIONS: Selected MKRN3 variants were present in 21.7 % of this cohort of Uzbek children with CPP. MKRN3-related CPP demonstrated genotype-specific morphological and endocrine features, particularly in girls. These findings suggest phenotypic heterogeneity and warrant confirmation in larger sequencing-based studies.

PMID:42402006 | DOI:10.1515/jpem-2026-0035

Aust Endod J. 2026 Jul 5. doi: 10.1111/aej.70106. Online ahead of print.

ABSTRACT

The aim of this study was to compare three delivery methods of a hydraulic calcium silicate cement-based sealer by quantifying voids using the single-cone technique. Forty-eight human mandibular molars were instrumented and scanned using micro-computed tomography. The specimen’s aspect ratio, shape, and volume were analysed to allow even distribution across three experimental groups (n = 16): sealer injection with a syringe, coating of the master cone and sealer injection followed by sonic agitation. Post-filling micro-computed scanning was used to quantify void volumes in each specimen. Statistical analysis using Kruskal-Wallis and Dunn’s post hoc tests (α = 0.05) revealed no significant difference in void volume among the delivery methods (p = 0.120). However, canal shape was a significant factor; round canals exhibited significantly fewer voids than any other shape (p < 0.001). In conclusion, the delivery method did not influence the density of the root canal filling; canal anatomy was the more critical determinant factor for void formation.

PMID:42402002 | DOI:10.1111/aej.70106

Aust Endod J. 2026 Jul 5. doi: 10.1111/aej.70108. Online ahead of print.

ABSTRACT

This study aimed to compare the ability of three artificial intelligence-based large language models, ChatGPT-4, Copilot, and Gemini, to generate multiple-choice questions. Two position statements from the European Society of Endodontology were used as source documents. Each model produced forty questions using an identical prompt, and a total of 120 questions were assessed for distractor quality, ability to distinguish different performance levels, reliability, and content validity. Weighted Kappa, Kruskal-Wallis, and Mann-Whitney U post hoc tests were used for analysis. The inter-rater agreement ranged between 0.870 and 1.000. ChatGPT-4 produced the highest overall scores, and Gemini consistently received the lowest ratings. Overall scores differed significantly between Copilot and Gemini, and ChatGPT-4 and Gemini (p < 0.05), but all produced poorly constructed distractor options. The findings indicate that artificial intelligence-based tools can support the generation of assessment materials in endodontics; however, expert oversight remains essential to ensure accuracy, quality, and educational relevance.

PMID:42402001 | DOI:10.1111/aej.70108

Respir Res. 2026 Jul 4. doi: 10.1186/s12931-026-03766-4. Online ahead of print.

ABSTRACT

BACKGROUND: Lung-protective ventilation is a cornerstone of modern mechanical ventilation, yet real-world adherence to lung-protective targets remains suboptimal. While previous studies have established the physiological benefits of low tidal volume and driving pressure, clinical implementation is hindered by limited monitoring granularity and lack of real-time actionable feedback. This trial aims to evaluate whether a real-time, cloud-based algorithmic feedback platform can improve lung-protective ventilation delivery and contribute to better clinical outcomes in mechanically ventilated patients with ARDS.

METHODS: This multicentre, parallel-group, open-label randomised controlled trial will enrol 208 adult mechanically ventilated ICU patients with ARDS from nine adult ICUs across tertiary academic hospitals and regional referral centres in multiple provinces and municipalities in mainland China. Participants will be randomly assigned in blocks to receive either standard monitoring (Control group) or real-time respiratory mechanics feedback through a cloud-based platform (Intervention group). The intervention group will receive real-time alerts for lasting 72 h and ventilator reports every 24 h, integrating tidal volume, plateau pressure, driving pressure, mechanical power, and detected patient-ventilator asynchrony events. The primary outcome is the lung-protective ventilation achievement rate, defined as compliance with VT < 8 mL/kg predicted body weight, driving pressure < 15 cmH₂O, plateau pressure < 30 cmH₂O, and mechanical power < 17 J/min during the first 72 h after randomisation. Secondary outcomes include ventilator-free days at day 28, ICU length of stay, ventilator-associated complications, inflammatory biomarkers, clinician satisfaction, and predefined safety outcomes, including severe hypoxemia, severe hypercapnia/acidemia, barotrauma, and hemodynamic instability temporally associated with ventilator adjustments.

DISCUSSION: This study is, to our knowledge, among the first multicentre randomised controlled trials to evaluate a real-time algorithmic feedback platform designed to enhance lung-protective ventilation. The intervention is designed to provide continuous bedside feedback on ventilation mechanics and may enable more timely and standardised clinical adjustments, with the potential to facilitate lung-protective ventilation delivery. Triaiontl registration ClinicalTrials.gov Identifier NCT07307066 (Registration Date: 2025/12/02).

PMID:42401979 | DOI:10.1186/s12931-026-03766-4