Tag: nevin manimala

Pharmacol Res Perspect. 2025 Dec;13(6):e70204. doi: 10.1002/prp2.70204.

ABSTRACT

Medication errors, often linked to inadequate numeracy skills, pose significant risks to patient safety. To address this, Kent and Medway Medical School (KMMS) became the first UK medical school to integrate safeMedicate, a validated e-learning platform, into its Year 1 undergraduate medical curriculum. This study aimed to evaluate its impact on student engagement, numeracy competence, and confidence. The entire cohort of 111 first-year medical students (2024 intake) was introduced to the safeMedicate Essential Skills module within the Year 1 module titled Professional Development and Person-Centred Practice. Engagement was assessed via platform analytics (logins, time, completion), numeracy competence through a formative online test, and perceptions via an anonymous survey. Engagement was high, with students averaging 9.1 logins and 124.2 min on the platform. Completion rates were near universal (95%). The average test score was 85.4%, with 75% of students achieving ≥ 85%. Competency analysis showed strong performance in conceptual, calculation, and technical measurement skills. Survey responses indicated that 89% found safeMedicate helpful for test preparation and 83% reported increased confidence in numeracy. Students valued the clarity, usability, and practice-based learning approach. Early integration of safeMedicate demonstrated improved engagement, numeracy performance, and student confidence. Although limited to one institution and formative assessment, findings support continued use of structured digital tools to strengthen medication safety education. Embedding safeMedicate into undergraduate curricula may reduce prescribing errors and better prepare future doctors for safe clinical practice.

PMID:41319170 | DOI:10.1002/prp2.70204

Alzheimers Dement. 2025 Dec;21(12):e70971. doi: 10.1002/alz.70971.

ABSTRACT

Longitudinal data on risk factors at different ages across the lifecourse are essential for gaining important insights into how the timing and accumulation of exposure to risk factors influence the risk of Alzheimer’s disease and related dementias (dementia). With increased interest in the exposome and lifecourse research questions, there have been commensurate increases in data sources and methodological approaches for answering these questions using empirical data. Methodological approaches developed within specific disciplines have largely remained within disciplinary silos, despite their potential for broader applications. By enumerating these approaches in a single place, we aim to expand discovery in lifecourse dementia research and help investigators align their research questions with appropriate analytic methods. In doing so, we seek to guide methodological decision-making and ensure that researchers use appropriate statistical tools to answer important questions about the exposome and lifecourse risk factors for dementia. HIGHLIGHTS: Longitudinal exposure data are valuable for exposome and lifecourse research on dementia. Multiple methodological approaches exist to analyze such data, with different assumptions, advantages, and disadvantages. Some methodological approaches have been used predominantly in specific disciplines but may have wider utility. Additional research is needed to integrate added complexity from the co-occurrence of multiple exposures into existing methods. Comparisons between methods help researchers make informed decisions on the appropriate method for a specific research question.

PMID:41319155 | DOI:10.1002/alz.70971

Microbiologyopen. 2025 Dec;14(6):e70190. doi: 10.1002/mbo3.70190.

ABSTRACT

Salmonella is recognized as one of the foodborne bacterial infections. The bacterium spreads through contact with animals and ingestion of contaminated foods. This study aimed to determine the prevalence, risk factors, and antimicrobial susceptibility patterns of Salmonella from bulk milk at dairy farm level in Mekelle and Southeast Zones of Tigrai, Ethiopia. A cross-sectional study was carried out from January to June 2025. After taking the consent, sociodemographic, risk factors, and 203 bulk milk samples were collected from the dairy farms. Salmonella was isolated and identified through pre-enrichment, selective enrichment, selective media, and a series of biochemical tests. Antimicrobial susceptibility testing was conducted using the disk diffusion method. Stata v-16 was employed to determine the strength of the factors that associates with Salmonella. The prevalence of Salmonella was six (2.96%). Salmonella positivity showed statistically significant association with farms that don’t practice regular udder washing before milking, lack of knowledge about bacterial infections, and do not know that consumption of raw milk cause foodborne illness. Five (83.3%) isolates of Salmonella showed resistance to ampicillin and tetracycline, and four (66.7%) to streptomycin. All Salmonella isolates were susceptible to ceftazidime and cefotaxime. Three isolates of Salmonella showed multidrug resistance. The prevalence of Salmonella was low, but its presence in milk may be considered a potential risk to milk safety. Three Salmonella isolates showed resistance to four and six antimicrobial classes. The finding highlights the need for appropriate hygiene practices and the correct use of antibiotics in the farms.

PMID:41319139 | DOI:10.1002/mbo3.70190

J Hum Nutr Diet. 2025 Dec;38(6):e70175. doi: 10.1111/jhn.70175.

ABSTRACT

AIM: Given the limited literature internationally, this cross-sectional study explored associations between inpatient plate waste, food experience and meal quality.

METHODS: Eligible participants were adult inpatients ( $\ge$ 18 years) ordering the same meal as the scheduled test meal. The Meal Quality Audit Tool (MQAT) assessed the temperature and sensory quality of the test meal, the Hospital Food Experience Questionnaire (HFEQ) assessed patient meal experience and plate waste was visually estimated. Binary logistic regression analysis was used to identify factors associated with plate waste. Chi-squared or nonparametric t-tests were used to compare MQAT data with patient, audit and HFEQ data.

RESULTS: Eligible participants (n = 187) were (mean ± SD) 59 ± 21 years, 51% female, 73% hospital stay of < 1 week and 57% had data collected at lunch. Across 41 test meals audited, temperature was the only MQAT element not meeting targets. Most patients (68%, n = 120/176) had 0% or 25% plate waste and a median (IQR) HFEQ score of 91 (82-98). For every 1-point increase in patient food experience score, the odds of achieving lower plate waste (≤ 25% plate waste) increased by 5% (OR 0.953, p < 0.05). When temperatures of matched test meals met temperature targets, the odds of lower plate waste (≤ 25% plate waste) increased by 82% (OR 0.183, p < 0.01). Sensory meal quality was not associated with plate waste or food experience (p > 0.05).

CONCLUSION: Lower plate waste (≤ 25% plate waste) was associated with higher patient food experience and meal temperatures meeting temperature targets. However larger, multicentre studies involving diverse patient groups are required to confirm these relationships.

PMID:41319134 | DOI:10.1111/jhn.70175

Exp Dermatol. 2025 Dec;34(12):e70184. doi: 10.1111/exd.70184.

ABSTRACT

Discoid lupus erythematosus (DLE) is the most common variant of cutaneous lupus. Histopathology remains the gold standard for diagnosis, but it carries a risk of scarring in a disease already prone to cicatricial outcomes. Additionally, diagnostic delays may occur due to variable processing times, particularly in challenging cases. Line-field confocal optical coherence tomography (LC-OCT) is a novel non-invasive imaging technique offering high-resolution, histology-like features. This study evaluates its diagnostic accuracy in DLE by assessing concordance with histopathology. A cross-sectional study enrolled histologically confirmed DLE from three tertiary referral hospitals. Eleven histological criteria were assessed using LC-OCT and subsequently compared to histopathology. Concordance was evaluated using Cohen’s Kappa coefficient (K), with McNemar’s test applied to detect significant differences (α = 0.05). Twenty-eight patients with DLE participated in the study. LC-OCT demonstrated strong agreement with histopathology in key diagnostic features of DLE. Near-perfect concordance (K = 1, 100% agreement) was observed for interface dermatitis, dermal vessel dilation, epidermal atrophy, and incontinentia pigmenti. Substantial agreement was found for epidermal disarray (K = 0.85), spongiosis (K = 0.70), necrotic keratinocytes (K = 0.70), and infundibular dilation (K = 0.79). Overall, LC-OCT achieved a Cohen’s Kappa of 0.74 with 87.66% concordance, and no statistically significant differences were observed between the two methods (McNemar p = 0.627). LC-OCT is a rapid, effective, and non-invasive diagnostic tool for DLE, demonstrating strong concordance with histopathology and potential for early diagnosis and clinical implementation.

PMID:41319132 | DOI:10.1111/exd.70184

Epilepsia. 2025 Nov 30. doi: 10.1111/epi.70031. Online ahead of print.

ABSTRACT

OBJECTIVE: Although vagus nerve stimulation (VNS) is a well-established neuromodulation therapy for drug-resistant epilepsy, treatment outcomes remain heterogeneous. One possible source of variability lies in differing interpretations of seizure frequency ratings (SFRs). This study examined interrater reliability (IRR) in SFRs between (1) retrospective clinician-clinician chart reviews and (2) prospective caregiver-clinician reports, and explored sources of disagreement.

METHODS: Data were collected from the CONNECTiVOS database. In the retrospective cohort (n = 254), two clinicians independently reviewed medical records and rated seizure frequency across multiple timepoints. In the prospective cohort (n = 214), caregivers and clinicians independently reported SFR in children treated with VNS. IRR was assessed across different measurement thresholds, and potential causes of disagreement were analyzed.

RESULTS: Clinician-clinician agreement in retrospective chart reviews was excellent (intraclass correlation coefficient [ICC] > .90, Cohen κ > .80), with 18.8% divergent ratings and 4.8% exceeding the reliable change index. Disagreement was significantly associated with higher mean seizure frequency at baseline (p = .004) and at postoperative timepoints (p < .001). In the prospective caregiver-clinician comparison, agreement for absolute seizure frequency was poor (ICC < .50), with discrepancies in 86.5% of cases, although only 1.8% were statistically significant. When rating pairs diverged, clinicians more often reported lower absolute seizure frequencies (p = .002) and greater relative seizure reductions (p = .023) and were more likely to classify patients as achieving a 90% reduction (p = .043).

SIGNIFICANCE: This study highlights interrater variability in both retrospective and prospective SFR assessments, a finding systematically related to baseline seizure frequency. Coarser classifications (e.g., 50% or 90% seizure reduction) may improve agreement but reduce clinical nuance. Future efforts should focus on structured, patient-centered documentation and the development of objective outcome measures in VNS evaluation, particularly for children with high seizure burden.

PMID:41319125 | DOI:10.1111/epi.70031

Colorectal Dis. 2025 Dec;27(12):e70321. doi: 10.1111/codi.70321.

ABSTRACT

BACKGROUND: Excisional haemorrhoidectomy is often associated with intense post-operative pain and delayed recovery. Bacterial colonization may contribute to this discomfort, and metronidazole has been proposed as an analgesic adjunct. This study compared the analgesic efficacy of topical metronidazole with oral metronidazole.

METHODS: A systematic search was conducted in PubMed, Scopus, and the Cochrane Central Register through May 2025. Randomized controlled trials comparing topical metronidazole with oral metronidazole for post-operative pain after haemorrhoidectomy were included. Visual analogue scale (VAS) scores on post-operative days 1, 3, and 7 were pooled. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the I² statistic. Risk of bias (RoB 2) and certainty of evidence (GRADE) were evaluated.

RESULTS: Four RCTs involving 439 patients (218 topical, 221 oral) met inclusion criteria. No significant differences were found between topical and oral metronidazole at day 1 (MD -0.1; 95% CI -0.3 to 0.2; I² = 25%), day 3 (MD -0.4; 95% CI -1.3 to 0.6; I² = 94%), or day 7 (MD -0.2; 95% CI -1.0 to 0.5; I² = 90%).

CONCLUSION: Topical and oral metronidazole showed similar short-term analgesic efficacy after haemorrhoidectomy.

PMID:41319118 | DOI:10.1111/codi.70321

Orthod Craniofac Res. 2025 Nov 30. doi: 10.1111/ocr.70069. Online ahead of print.

ABSTRACT

BACKGROUND: This retrospective study aimed to evaluate the skeletal and dentoalveolar effects of maxillary expansion using the Invisalign First system in the mixed dentition.

METHODS: The study was conducted in the orthodontic department of the Fourth Affiliated Hospital of Zhejiang University School of Medicine between 2021 and 2024. Inclusion criteria were mixed dentition patients with maxillary transverse deficiency, fully erupted first molars, arch width discrepancy ≤ 5 mm, mild to moderate crowding and pre-peak growth status (CS2). Exclusion criteria were Angle’s Class III malocclusion, previous orthodontic treatment, congenitally missing teeth, TMJ disorders, cleft lip/palate, or use of additional appliances. All patients were treated with a standardised digital protocol using the Invisalign First system with optimised expansion support attachments. No additional buccal root torque was programmed, and Class II elastics were not used. Pre- and post-treatment intraoral scan digital models and cone-beam computed tomography data were obtained. Measured parameters included arch width, nasal width, apical base width, alveolar width, palatal depth and first molar inclination. Statistical analyses were performed using paired t-tests for normally distributed data and Wilcoxon signed-rank tests for non-normally distributed data, with a significance level set at p < 0.05.

RESULTS: The study included 45 patients (mean age 8.84 ± 1.01 years; mean treatment duration 18.26 ± 0.95 months). Significant transverse increases were observed in all maxillary arch widths, particularly in the canine and deciduous molar regions (canine dental width: 4.17 ± 1.91 mm, p < 0.001; first deciduous molar width: 3.86 ± 1.93 mm, p < 0.001; second deciduous molar width: 4.38 ± 1.78 mm, p < 0.001). Corresponding significant expansion was noted at the alveolar bone level (anterior alveolar process width: 4.04 ± 3.37 mm, p < 0.001; posterior alveolar process width: 2.51 ± 1.71 mm, p < 0.001). The maxillary first molars showed controlled buccal inclination of 1.6° ± 4.09° (p < 0.01). The upper arch perimeter increased by 3.68 ± 2.95 mm (p < 0.001) with crowding reduction of 3.83 ± 3.00 mm (p < 0.001). No significant palatal depth changes occurred (0.42 ± 3.36 mm, p = 0.41).

CONCLUSION: In the mixed dentition, the Invisalign First system can effectively expand the maxillary dental-alveolar width, maintain molar inclination and improve the transverse deficiencies and arch form in the canine-premolar region.

PMID:41319100 | DOI:10.1111/ocr.70069

J Cell Mol Med. 2025 Dec;29(23):e70962. doi: 10.1111/jcmm.70962.

ABSTRACT

Lung cancer prognosis varies significantly among patients, highlighting the need for accurate prediction tools. Emerging evidence suggests that the immune microenvironment plays a crucial role in lung cancer progression and treatment response. We collected RNA expression profiles and clinical data of lung cancer patients from TCGA and GEO databases. Differential expression analysis identified 276 lung cancer-associated genes using strict statistical criteria (logFC > 1, FDR < 0.05). Unsupervised consensus clustering divided patients into ‘lung cancer-related’ and ‘non-lung cancer-related’ subgroups. We evaluated 10 machine learning algorithms and 101 algorithmic combinations for prognostic model development. Single-cell RNA sequencing data were analysed using Seurat and CellChat to investigate immune cell interactions within the lung cancer microenvironment. Our prognostic model demonstrated excellent predictive performance with AUC values of 0.874, 0.891 and 0.925 at 1, 2 and 3 years, respectively (C-index = 0.874). Six key immune genes (TLR2, TLR4, CCR7, IL18, TIRAP and FOXP3) showed cell-type specific expression patterns in the lung cancer microenvironment. Intercellular communication analysis revealed complex signalling networks between B cells, T cells, NK cells and dendritic cells. CIBERSORT and ESTIMATE analyses confirmed significant differences in immune infiltration between high-risk and low-risk patients, with distinct patterns of T cell subsets, macrophages and dendritic cells. This study provides a reliable prognostic tool for lung cancer and offers insights into the critical role of the immune microenvironment in lung cancer pathogenesis. Our findings may guide the development of personalised immunotherapy strategies for lung cancer patients.

PMID:41319095 | DOI:10.1111/jcmm.70962

J Nepal Health Res Counc. 2025 Oct 17;23(2):282-287. doi: 10.33314/jnhrc.v23i02.4848.

ABSTRACT

BACKGROUND: Lack of a structured referral system is a challenging hurdle in developing countries like Nepal that delays in management. Identification causes of delays and their timely management is of immense importance. The study aimed to assess the maternal and fetal outcome of referred-in obstetric patients and to identify various maternal determinants of referrals inParopakar Maternity and Women’s Hospital.

METHODS: A prospective study was conducted during 3 months duration from May to June 2021 among undelivered obstetric cases who were referred to Paropakar Maternity and Women’s Hospital. Study excluded self-referrals, without referral slips and postpartum patients. Maternal determinants, mode of management, maternal and fetal outcomes were noted.

RESULTS: Out of 47 cases enrolled, most common diagnosis of referral was hypertensive disorder accounting for 19.14% followed by intrauterine growth restriction comprising 10.6%. Of total, 55.3% of referred patients were from the district hospitals. Ambulances rescued 78.7% of cases and 10.6% were rescued by helicopter. About 12.7% of the referred cases required intensive care management. Live birth were 86.3%, still birth 4.5% and 9.1% of Intrauterine Fetal Death.

CONCLUSIONS: Among the varied high risk cases, most common diagnosis at the time of referral was hypertensive disorders followed by cases requiring critical care and surgical management. This highlights need and scope of strengthening emergency obstetric care centres and early identification and treatment of high risk cases antenatally at every level of health centres.

PMID:41319084 | DOI:10.33314/jnhrc.v23i02.4848