Tag: nevin manimala

Influenza Other Respir Viruses. 2025 Jan;19(1):e70068. doi: 10.1111/irv.70068.

ABSTRACT

BACKGROUND: The global pandemic caused by SARS-CoV-2 has resulted in millions of people experiencing long COVID condition, a range of persistent symptoms following the acute phase, with an estimated prevalence of 27%-64%.

MATERIALS AND METHODS: To understand its pathophysiology, we conducted a longitudinal study on viral load and cytokine dynamics in individuals with confirmed SARS-CoV-2 infection. We used reverse transcriptase droplet digital PCR to quantify viral RNA from nasopharyngeal swabs and employed multiplex technology to measure plasma cytokine levels in a cohort of people with SARS-CoV-2 infection. Our study included individuals with long COVID condition and those without, all of whom had at least three nasopharyngeal and plasma samples collected within 55 days after diagnosis of SARS-CoV-2 infection.

RESULTS: Individuals affected with long COVID symptoms had delayed viral clearance and lower viral loads at diagnosis compared to those without symptoms. Additionally, cytokine analysis revealed variations in IL-18, MIG, and IP-10 levels, with delayed normalization in individuals affected by long COVID syndrome. Correlation analysis indicated associations between viral load and IP-10 and interrelations among cytokines IL-1β, IL-18, MIG, and IP-10.

CONCLUSION: Our study provides insights into the association between nasopharyngeal viral load, cytokine dynamics, and the development of long COVID syndrome, providing an early signature of this condition.

PMID:39800769 | DOI:10.1111/irv.70068

Nat Commun. 2025 Jan 12;16(1):610. doi: 10.1038/s41467-025-55911-0.

ABSTRACT

People living with HIV are at higher risk of heart failure and associated left atrial remodeling compared to people without HIV. Mechanisms are unclear but have been linked to inflammation and premature aging. Here we obtain plasma proteomics concurrently with cardiac magnetic resonance imaging in two independent study populations to identify parallels between HIV-related and aging-related immune dysfunction that could contribute to atrial remodeling and clinical heart failure. We discover a plasma proteomic signature that may in part reflect or contribute to HIV-associated atrial remodeling, many features of which are associated with older age and time to incident heart failure among an independent community-based cohort without HIV. This proteomic profile was statistically enriched for immune checkpoint proteins, tumor necrosis factor signaling, ephrin signaling, and extracellular matrix organization, identifying possible shared pathways in HIV and aging that may contribute to risk of heart failure.

PMID:39800750 | DOI:10.1038/s41467-025-55911-0

Trop Med Health. 2025 Jan 13;53(1):4. doi: 10.1186/s41182-024-00679-0.

ABSTRACT

BACKGROUND: Oromia regional state experiencing cholera outbreaks in a protracted pattern despite various interventions at local and regional levels. This study aimed to examine the implementation of Risk Communication and Community Engagement (RCCE) activities for cholera outbreak control in the region.

METHODS: We conducted a quantitative and qualitative mixed-method study. The study included 422 respondents for quantitative, 22 key informant interviews (KII), and 4 Focus Group Discussions (FGDs) for the qualitative methods. Risk Communication and Community Engagement (RCCE) activities were assessed using standard questionnaires adapted from national cholera guideline later categorized as poor, satisfactory and good. The findings have also been derived qualitatively from three distinct themes or pillars, specifically (coordination and logistics, RCCE, and the Oral Cholera Vaccine). The quantitative data were analyzed using Stata, version 14.0, and ATLAS.ti9 software was used for qualitative data analysis. An ordinal logistic regression model was applied to identify factors associated with the RCCE status, and a thematic content analysis was performed for the qualitative study. Odds Ratios with 95% confidence intervals (CI) were used to present the findings from the quantitative analysis.

RESULTS: Only 53% (223) of participants had received health information on cholera of whom 22.8% (96) had material for Social Behaviour Change (SBC) in the local language (Afan Oromo). The overall RCCE implementation status was rated as poor by 73% of the respondents, satisfactory by 23%, and only 4% rated it as good. Level of education and occupation of the house are among the factors affecting the implementation of RCCE. The qualitative findings revealed a lack of regular community dialogues, and community engagements were notably minimal during the early phase of the outbreak. Overall, the RCCE implementation activities were characterized by inconsistency, a lack of comprehensiveness, and uniformity across all levels.

CONCLUSION: The RCCE-related intervention activities were found to be minimal, inconsistent and less focused. The RCCE interventions and awareness creation need to begin with the small units of the community structures, including individuals and families and have to happen continuously with the community, and health workers’ involvement at all level. Preliminary evaluation of Social and Behaviour Change (SBC) materials before their distribution should be made, and adopting diverse communication modalities to control the outbreak.

PMID:39800749 | DOI:10.1186/s41182-024-00679-0

BMC Health Serv Res. 2025 Jan 13;25(1):62. doi: 10.1186/s12913-025-12208-8.

ABSTRACT

PURPOSE: Understanding patient experience is crucial for advancing patient-centered care and improving hospital service quality. This study aimed to design and validate a Persian version of a patient experience assessment questionnaire to evaluate hospital services.

METHODS: This descriptive-analytical study on tool development was conducted cross-sectionally during 2021-2022 in Iran. The study consisted of two stages: (1) In the first stage, a deductive approach and comprehensive literature review were employed to develop the initial questionnaire items, based on the framework from prior research titled “Developing a Model for Evaluating Patient Experience in Teaching Hospitals in Iran.” (2) In the second stage, validation was carried out by assessing face validity, content validity (using expert panels to evaluate the Content Validity Index (CVI) and Content Validity Ratio (CVR)), and construct validity through confirmatory factor analysis. Sampling for the face validity stage included 30 randomly selected patients, while construct validity was assessed with a sample of 340 participants, of which 300 provided complete and valid data. Reliability was determined using internal consistency (Cronbach’s alpha) and stability (intra-cluster correlation coefficient) measures.

RESULTS: The initial questionnaire comprised 44 items. Following expert reviews and validation processes, 10 items were removed, resulting in a final version with 33 items. The confirmatory factor analysis confirmed the five-dimensional structure, with a Cronbach’s alpha of 0.97 and an intra-cluster correlation coefficient of 0.89, indicating strong internal consistency and reliability.

CONCLUSION: This study successfully developed and validated a 33-item questionnaire for assessing patient experience in Iranian hospitals, ensuring cultural relevance and robust psychometric properties.

PMID:39800734 | DOI:10.1186/s12913-025-12208-8

Sci Rep. 2025 Jan 13;15(1):1773. doi: 10.1038/s41598-025-85524-y.

ABSTRACT

In this paper, explore the effectiveness of a new Wide Area Fuzzy Power System Stabilizer (WAFPSS), optimized using the Exponential Distribution Optimization (EDO) algorithm, and applied to an IEEE three-area, six-machine power system model. This research primarily focuses on assessing the stabilizer’s capability to dampen inter-area oscillations, a critical challenge in power grid operations. Through extensive simulations, the study demonstrates how the WAFPSS enhances stability and reliability under a variety of operational conditions characterized by different communication delay patterns. The application of the proposed stabilizer on this specific IEEE model provides a detailed insight into its performance in real-world scenarios, illustrating its adaptability and effectiveness in managing dynamic disturbances. The simulation results reveal that the proposed WAFPSS achieves significant reductions in the Integral Time Squared Error (ITSE), with improvements of 94.1%, 97.02%, and 98.18% in three distinct cases, showcasing its superior damping capability and robustness. The findings indicate that the advanced optimization techniques provided by the EDO algorithm significantly improve the stabilizer’s response, ensuring robust power system performance. This integration of WAMS with sophisticated control systems using fuzzy logic presents a strategic solution to managing the complexities faced by modern power networks, optimizing their stability in the face of increasing renewable integration and fluctuating demand.

PMID:39800722 | DOI:10.1038/s41598-025-85524-y

Infect Dis Poverty. 2025 Jan 13;14(1):2. doi: 10.1186/s40249-024-01269-2.

ABSTRACT

BACKGROUND: The cytochrome P450s-mediated metabolic resistance and the target site insensitivity caused by the knockdown resistance (kdr) mutation in the voltage-gated sodium channel (vgsc) gene were the main mechanisms conferring resistance to deltamethrin in Culex quinquefasciatus from Thailand. This study aimed to investigate the expression levels of cytochrome P450 genes and detect mutations of the vgsc gene in deltamethrin-resistant Cx. quinquefasciatus populations in Thailand.

METHODS: Two field-collected strains of Cx. quinquefasciatus, Cq_SP and Cq_NiH, were selected with deltamethrin to generate the resistant strains Cq_SP-R and Cq_NiH-R, respectively. Bioassays were tested on larvae and adults of each strain according to WHO methods. Eight cytochrome P450 genes were analyzed for the expression level using quantitative real time-PCR. The cDNA of mosquitoes was amplified and sequenced for four fragments of vgsc gene. The kdr L1014F mutation and the haplotype of the CYP9M10 gene were detected in survivor and dead mosquitoes after exposure to the deltamethrin WHO test paper. Statistical analyses were performed using Fisher’s exaction test.

RESULTS: Bioassay tests revealed a significantly higher resistance level in Cq_SP-R than in Cq_NiH-R strains in both larvae and adults. All eight cytochrome P450 genes were significantly overexpressed in larvae of Cq_NiH-R strain compared to the parent and susceptible Cq_Sus strains. The CYP6AA7 and CYP9J34 genes had the highest expression ratios, exceeding 24-fold in Cq_NiH-R larvae. In Cq_SP-R strain, the CYP4H34 and CYP9J34 genes were overexpressed in both stages. The kdr L1014F mutation was found in Cq_SP-R and its parent Cq_SP strains with a significantly higher mutant allele frequency in the survivor mosquitoes than in dead mosquitoes (P < 0.0001). The V240M and novel L925F mutations were found only in Cq_SP-R strain. Heterozygous genotype for the D-Cu( +)/Cu(-) of CYP9M10 gene was detected in Cq_NiH and Cq_NiH-R strains but other strains were mostly homozygous for the Cu(-)/Cu(-).

CONCLUSIONS: Overexpression of multiple cytochrome P450 genes alone has a relatively minor impact on resistance. The combined mechanisms of cytochrome P450- and kdr-mediated resistance result in significantly higher resistance to deltamethrin in Cx. quinquefasciatus. This study supports sustainable public health initiatives in Thailand to address the evolving challenges of insecticide resistance.

PMID:39800715 | DOI:10.1186/s40249-024-01269-2

BMC Med Educ. 2025 Jan 12;25(1):52. doi: 10.1186/s12909-025-06644-7.

ABSTRACT

BACKGROUND: Despite the importance of effective educational strategies to promote the transformation and articulation of clinical data while teaching and learning clinical reasoning, unanswered questions remain. Understanding how these cognitive operations can be observed and assessed is crucial, particularly considering the rapid growth of artificial intelligence and its integration into health education. A scoping review was conducted to map the literature regarding educational strategies to support transformation and articulation of clinical data, the learning tasks expected of students when exposed to these strategies and methods used to assess individuals’ proficiency METHODS: Based on the Joanna Briggs Institute methodology, the authors searched 5 databases (CINAHL, MEDLINE, EMBASE, PsycINFO and Web of Science), ProQuest Dissertations & Theses electronic database and Google Scholar. The data were synthesized narratively using descriptive statistics.

RESULTS: A total of 38 articles were included in the final synthesis. Most studies were conducted in North America and Europe (n = 30, 79%) focused primarily on medical students (n = 35, 92%) and mainly used observational (n = 17, 45%) or methodological (n = 8, 21%) designs. Various educational strategies were identified, the most common were resolution of written or computerized case-based scenarios (n = 13; 52%) and simulated or real patient encounters (n = 6; 24%). The learning tasks comprised, among others, identifying key findings, translating clinical information, synthesizing cases aloud, and writing a summary statement. Furthermore, the review included assessment methods and rubrics with assessment criteria for clinical data transformation and articulation. The narrative synthesis shows positive results when integrating various educational strategies within clinical reasoning curricula compared to a single strategy used episodically.

LIMITATIONS AND CONCLUSIONS: The varying objectives, diversity of educational strategies documented, and heterogeneity of the evaluation tools or rubrics limit our conclusions. However, insights gained will help educators develop effective approaches for teaching clinical reasoning. Additional research is needed to evaluate the impacts of educational strategies aimed at developing skills for the transformation and articulation of clinical data.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:39800713 | DOI:10.1186/s12909-025-06644-7

Nurs Health Sci. 2025 Mar;27(1):e70023. doi: 10.1111/nhs.70023.

ABSTRACT

The aim of this study is to determine the mediating role of moral sensitivity in the effect of nurses’ professional values on missed nursing care. A descriptive and correlational study was conducted with 640 nurses working in the inpatient units of a public and a private hospital with the MISSCARE Survey-Turkish, the Moral Sensitivity Questionnaire, and the Revised Nursing Professional Values Scale. Data analyses were performed using the Statistical Package for Social Sciences 26.0, Hayes’ PROCESS macro for SPSS v4.0, and the Analysis of Moment Structures 24.0. It was determined that nurses’ professional values had a significant and positive effect on moral sensitivity, and nurses’ moral sensitivity had a significant and negative effect on missed nursing care. In addition, the direct and indirect effects of nurses’ professional values on missed nursing care were statistically significant. The research model showed that increasing nurses’ professional values and moral sensitivity decreased missed nursing care, and moral sensitivity significantly mediated the interaction between nurses’ professional values and missed nursing care.

PMID:39799606 | DOI:10.1111/nhs.70023

J Eval Clin Pract. 2025 Feb;31(1):e14225. doi: 10.1111/jep.14225.

ABSTRACT

OBJECTIVE: To examine the medical students’ awareness of laparoscopic surgery as well as assess the perceived importance of laparoscopic simulation training, and its impact on students’ confidence, career aspirations, proficiency, spatial skills, and physical tolerance.

DESIGN: Descriptive and comparative study using pre- and post-training assessments.

SETTING: Simulation training sessions centred on laparoscopic surgery techniques.

PARTICIPANTS: Medical students in year three (n = 49) participated in laparoscopic simulation training sessions.

RESULTS: Before the simulation training, 85.7% of students were unaware of laparoscopy, with females being less familiar than males (96.3% vs. 72.8%). 85.7% believed mastering laparoscopy was crucial before training, and 81.6% believed simulation training could enhance surgical skills. A disparity existed in this belief between the sexes, with 91% of males and 74.1% of females seeing the value in such training for skill improvement. Pretraining, males (54.5%) were more confident than females (26%) in mastering laparoscopy. Post-training, confidence increased for both groups, and the percentage of students wishing to pursue a surgical career also rose from 50% to 72.7%. Despite initial disparities in the time spent on training modules between males and females, both groups achieved similar proficiency levels by the end of the training. Although females initially lagged in spatial awareness and skills, post-training results showed significant improvement, matching their male counterparts. 26.5% of students experienced physical fatigue post-training, with a higher percentage of females (33.3%) reporting fatigue than males (18.2%). Regarding concentration during simulations, 81.8% of males could maintain focus compared to 48.2% of females.

CONCLUSIONS: Laparoscopic simulation training effectively improved the understanding, confidence, and surgical skills of medical students, with evident benefits in shaping their career aspirations. While both genders exhibited significant gains, female students faced challenges in terms of physical tolerance and initial spatial awareness. However, their post-training achievements mirrored those of their male peers, highlighting the effectiveness and importance of such simulation training programmes.

PMID:39799586 | DOI:10.1111/jep.14225

Eur J Trauma Emerg Surg. 2025 Jan 12;51(1):8. doi: 10.1007/s00068-024-02671-z.

ABSTRACT

BACKGROUND AND IMPORTANCE: Traumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.

OBJECTIVES: The objective of this study is to identify which factors additional to tICH affect the risk of this outcome and to evaluate the differences in the risk of adverse outcome in younger and older mTBI patients with tICH.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective study assessed adult (≥ 16 years) mTBI patients with tICH admitted to a Level 1 trauma center between January 2017 and October 2020.

OUTCOME MEASURES AND ANALYSIS: Patients were stratified into two groups, age < 65 years and age ≥ 65 years. Adverse outcome due to tICH was assessed using a composite adverse outcome which comprised either, a drop in GCS by more than 1 point, progression of or new neurological deficits, seizure activity, progression of tICH on repeated neuroimaging after clinical deterioration, a neurosurgical intervention, a readmission within three months of injury related to TBI, or death. Logistic regression analysis was used to identify independent predictors of the composite adverse outcome.

MAIN RESULTS: In total, 332 mTBI patients with tICH were enrolled in our study. Older mTBI patients with tICH met the criteria for the composite adverse outcome significantly more often than younger patients (12.6% 95% CI 8.0-17.0% vs. 4.9%, 95% CI 1.0-9.0%, p = 0.033). The univariate analysis showed that a neurological deficit (OR 6.55, 95% CI 2.37-18.08) or a SDH on admission (OR 3.13, 95% CI 1.40-6.99) was positively associated with the composite adverse outcome in older patients. The presence of isolated traumatic SAH (tSAH) was associated with a decreased risk of the composite adverse outcome (OR 0.10, 95% CI 0.01-0.71). Multivariate analysis was not possible.

CONCLUSION: Serious adverse outcomes are frequently observed in older mTBI patients with tICH. Nonetheless, our findings suggest that older patients with an isolated tSAH are at low-risk for deterioration and may be directly discharged from the ED after a short period of observation.

PMID:39799536 | DOI:10.1007/s00068-024-02671-z