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Large language model tools are increasingly used in higher education, offering opportunities to support self-directed learning. In nursing education, course-specific AI virtual tutors may provide contextualised support while addressing concerns about content accuracy and alignment; yet empirical evidence remains limited.
This study evaluated the use and perceived impact of a co-designed AI-powered virtual tutor embedded in a graduate-level Master of Nursing (MN) course. We explored how students used the tutor, their perceptions of benefits and limitations, and its influence on learning and engagement.
A pilot study using a mixed-methods explanatory sequential design was employed. The tutor was trained on course-specific materials and integrated into the institutional learning management system. Data included anonymised usage logs and user interactions coded using Bloom's Taxonomy of Educational Objectives, post-course surveys assessing AI self-efficacy, usability, and learning impact, and semi-structured interviews with students and teaching assistants (TAs). Quantitative and qualitative strands were integrated through a joint display.
A total of 651 interactions by individuals within a group of ~120 MN students were logged. Interactions peaked in evenings and around assignment deadlines. Most interactions reflected lower-order education processes, with more application and analysis later in the course. Eleven participants completed surveys; students reported high AI self-efficacy and moderate tutor use. Perceived usefulness was mixed, but most reported the tutor enhanced both lower- and higher-level learning and recommended its future use. Interviews revealed that students valued the tutor's immediacy and course-specific accuracy, while TAs noted efficiency gains. Reported challenges included usability issues, scope limitations, privacy concerns, and risk of over-reliance on the tool.
A co-designed AI virtual tutor was feasible and valued for contextual relevance, though perceived usefulness was variable. Findings support responsible, pedagogically integrated use of AI tutors in graduate nursing education.
Medical device-related pressure injuries (MDRPIs) are a patient safety concern in acute and critical care settings. Registered nurses must implement preventive strategies, yet gaps remain in their knowledge, attitudes, and clinical practices related to MDRPI prevention. This study aimed to evaluate the effectiveness of a structured educational intervention in improving registered nurses' knowledge, attitudes, and practices related to MDRPI prevention. A quasi-experimental pre–post intervention study was conducted in a tertiary care hospital in Saudi Arabia, with 311 registered nurses participating. Data were collected using a questionnaire assessing knowledge, attitudes, and practices related to MDRPI prevention. Participants received a one-day structured educational program based on the knowledge, attitude, practice (KAP) framework and the evidence-based SKINCARE bundle. The educational intervention resulted in significant improvements. Mean scores increased from 14.17 (SD = 2.38) pre-intervention to 16.25 (SD = 1.97) post-intervention (t = −11.81, p < 0.001). The intervention demonstrated a moderate-to-large effect size (Cohen's d = 0.67), indicating meaningful improvement in nurses' preventive competencies. Structured educational programs can enhance registered nurses' knowledge and practices in MDRPI prevention. Integrating evidence-based training programs into routine hospital education may strengthen pressure injury prevention guidelines and improve patient safety outcomes.
Pressure injuries are largely preventable yet remain common in hospital care. This multi-hospital study assessed nurses' knowledge, attitudes and practices for prevention in governmental, private and charitable hospitals in Nablus, Palestine, and examined links with professional characteristics. A descriptive cross-sectional study was conducted in six hospitals in Nablus city, Palestine. A total of 231 registered nurses were recruited using convenience sampling and completed a content-validated, self-administered questionnaire assessing demographics, knowledge (20 items), attitudes (11 items), and practices (17 items). Data were analysed using descriptive statistics, one-way analysis of variance with Tukey post hoc tests, and binary logistic regression for adequate knowledge and practice (≥ 80%). Overall, 64.5% demonstrated adequate knowledge, and 58.0% expressed a favourable attitude. Practice adherence averaged 70.9 ± 16.3 out of 100. Only 31.6% achieved ≥ 80%, indicating suboptimal practice in most participants. Key gaps involved massage avoidance and the use of lifting devices. Knowledge was higher with recent PI training (1–2 years vs never: OR = 4.110, 95% CI 1.622–10.414, p = 0.003; 2–3 years vs never: OR = 3.047, 95% CI 1.208–7.687, p = 0.018). Practice adequacy was higher with training < 1 year ago vs never (OR = 4.146, 95% CI 1.636–10.512, p = 0.003). Other adjusted associations were imprecise and treated as exploratory. Nurses showed generally adequate knowledge, whereas routine preventive practice remained less consistent. Recent training was associated with better knowledge and practice, suggesting that targeted education, supervised skills training, unit-level protocols and audit with feedback may support improvement.
Burns are a major cause of morbidity in Yemen, and their prevention relies heavily on community knowledge and safe practices. Understanding gaps in awareness and behaviour is essential for designing effective interventions. This study assessed the knowledge, attitudes and practices (KAP) regarding burn prevention and first aid among a Yemeni community. A cross-sectional survey was conducted among 380 participants using a structured questionnaire distributed via social media and community networks. Data were collected on demographics, educational level, occupation, residential area and KAP related to household, electrical and chemical burns. Associations between participant characteristics and burn-related KAPs were analysed. Participants were predominantly female (63.7%), aged 15–45 years (79.8%), urban residents (92.9%) and university-educated (82.1%). Healthcare workers comprised 50.8% of respondents. Knowledge of burn prevention and first aid was highest among university-educated and healthcare participants, with 84.6% correctly identifying initial burn management. Unsafe practices, such as applying honey or toothpaste and improper handling of chemical or electrical injuries, were more common among less-educated, rural and nonhealthcare respondents. Urban participants demonstrated better preventive practices, while cultural reliance on traditional remedies persisted across all groups. Among predominantly urban and educated populations in Yemen, knowledge and attitudes toward burn prevention and first aid are generally favourable; however, gaps persist, particularly in rural and less-educated communities. Cultural practices and misconceptions continue to limit optimal care. These findings underscore the urgent need for culturally sensitive, literacy-appropriate, community-based interventions to improve burn prevention, first aid practices and equitable health outcomes.
Climate change has led to extreme heat events, disproportionately affecting vulnerable populations. Heat stress during pregnancy is linked to adverse health outcomes, yet the biological mechanisms remain poorly understood. This research study aims to investigate the effect of environmental heat on maternal, fetal and infant health and examine the biological pathways linking heat stress to adverse pregnancy outcomes.
This prospective cohort study will recruit 6000 pregnant women from three districts in Sindh, Pakistan. Eligible participants ≥18 years old, will have a minimum of five scheduled visits from
The study has received ethical approval from the Aga Khan University (AKU) (Ref: 26249) and the Pakistan National Bioethics Committee (Ref: 1065/23/1736). Written informed consent will be obtained from all participants before enrolment. Referral pathways to healthcare facilities will be established to ensure timely management of pregnancy complications. Findings will be disseminated through peer-reviewed publications, scientific conferences, and engagement with policymakers and public health stakeholders to inform climate-resilient maternal health strategies. Results will also be shared with participants and communities through meetings and informal sessions to raise awareness and support evidence-based heat adaptation.
This study aimed to quantify how patient risk factors relate to COVID-19 severity across categories 1–5 in a prospective, hospital-based cohort. We hypothesised that greater severity would be associated with higher odds of intensive care unit (ICU) admission and in-hospital mortality. Secondary aims were to assess associations with age, viral variants, symptom clusters, lymphocyte count, fasting blood glucose and cytokine profiles.
Prospective cohort study.
A secondary-care/tertiary-care hospital and linked community settings in Cheras, Kuala Lumpur, Malaysia.
This study was nested within the COVGEN project, a prospective COVID-19 cohort conducted at Hospital Canselor Tuanku Muhriz UKM (HCTM), Cheras Health Clinic and the Bandar Tun Razak COVID-19 Assessment Centre in Cheras, Kuala Lumpur, Malaysia, from 1 August 2021 to 31 October 2022. 2532 participants were enrolled at baseline. Eligible participants were Malaysian citizens aged 12–18 years (paediatric/adolescent) or ≥18 years who had reverse transcription-polymerase chain reaction–confirmed COVID-19 at recruitment and resided in Kuala Lumpur or Selangor. Patients who had a clinically unstable condition and those who declined participation (personally or via a next-of-kin or legal representative) were excluded. This analysis included 559 patients hospitalised at HCTM; after excluding five with incomplete questionnaires, 554 remained for analysis (413 admitted to general wards and 141 to ICUs). Categories 3–5 comprised hospitalised patients, whereas categories 1–2 included hospitalised individuals and a subset recruited from community settings.
Primary outcomes included disease severity (categories 4–5 vs 1–3), ICU admission and in-hospital mortality. Secondary outcomes included associations with age strata, viral variant (delta vs omicron), symptom clusters, lymphocyte count, fasting blood glucose and cytokines: interferon gamma-inducible protein 10, interferon gamma, interleukins 8, 10, 2, 6 and 7 and tumour necrosis factor alpha.
141 of 554 (25.5%) patients required ICU care. Compared with milder categories, category 5 was associated with markedly higher odds of ICU admission (OR 204.50; 95% CI 37.54 to 1114.18; p55 versus
An increasing clinical severity category was strongly associated with ICU admission and mortality. Age, delta infection, specific symptom clusters, lymphopenia, hyperglycaemia and pro-inflammatory cytokines identified higher-risk patients, supporting risk-stratified management and prioritisation for enhanced monitoring.
by Seid Mohammed Abdu, Hussen Abdu, Endris Seid Muhaba, Ebrahim Msaye Assefa, Gosa Mankelkl
BackgroundThe sciatic nerve (SN), the longest and largest nerve in the body, arises from the L4-S3 nerve roots and exits as a single trunk below the piriformis muscle through the greater sciatic foramen. However, variations in its anatomy are common, believed to originate from embryological development. These variations show significant racial and geographical differences, which have often been overlooked in previous review studies. Therefore, this meta-analysis aims to address this gap by systematically reviewing global data to evaluate the impact of race on sciatic nerve variations.
MethodsA systematic review and meta-analysis were conducted to assess the pooled prevalence of SN variations among racial subgroups. A comprehensive literature search was performed using PubMed, Google Scholar, Hinari, and additional sources, including major anatomical journals and cross-referenced articles. Subgroup analyses by region and country were also conducted using a random-effects model. Heterogeneity was assessed with the Cochrane Q test and the I² statistic.
ResultsType A, considered the normal pattern, had the highest pooled prevalence at 86%. The remaining 14% represented variations of the sciatic nerve (SN). Among these, Type B was the most common at 7%, followed by Type C and G each observed in 2% of limbs, while less frequent variations included Type Type D (1%), Type E (0%), and Type F (0% (0–1)). Racial analysis showed that SN variations occurred in 15% of Asians, 12% of Whites, and 13% of Blacks. Regarding continents, the highest prevalence was in Asia with 15%, the second highest prevalence was observed in Europe with 14%, followed by Africa with 13%, and the lowest in America with 11%. No significant differences were found among the races and continents. However, East Asia showed the highest significant prevalence, with China at 35% and Japan at 32%.
ConclusionThis review revealed only modest and statistically non-significant differences in the prevalence of sciatic nerve variations across broad racial and continental groups. In contrast, substantial variation was observed at the regional level, with particularly high prevalence rates in East Asian countries, specifically China and Japan. These findings suggest that regional factors contribute more to the observed variations than racial factors.
To assess the levels of knowledge, attitudes and practices (KAP) toward skin cancer prevention among Malaysian adults and to examine differences in KAP across socio-demographic groups.
Cross-sectional online survey.
Community-based study conducted in Malaysia using social media recruitment.
A total of 386 adults aged ≥18 years residing in Malaysia. Most participants were young adults (86.3%), female (55.4%) and of Chinese ethnicity (65.5%). Healthcare professionals were excluded.
Primary outcomes were levels of knowledge, attitude and preventive practices toward skin cancer, measured using the validated KAP-SC-Q (Knowledge, Attitude and Practice of Skin Cancer Questionnaire) and categorised as poor, moderate or good. Secondary outcomes included differences in KAP across socio-demographic and clinical characteristics, analysed using independent t-tests and 2 tests.
Over half of participants demonstrated poor knowledge of skin cancer (56.0%) and the vast majority showed inadequate preventive practices (84.2%), while attitudes toward skin cancer were predominantly positive (62.4%). Significant differences in mean KAP scores and categorical levels were observed across several socio-demographic variables. Participants with tertiary education had higher knowledge (14.32 vs 12.61) and attitude scores (20.01 vs 15.95; p
Malaysian adults exhibited limited knowledge and very poor preventive practices toward skin cancer despite generally positive attitudes. These findings highlight substantial gaps between awareness and behaviour and support the need for targeted public health interventions to correct misconceptions, improve risk perception especially in high-risk groups and promote effective ultraviolet protection behaviours.
Older adults face growing risks of depression and anxiety, yet stigma, comorbidities, cost, and limited access impede receipt of conventional care. Digital mental health interventions (DMHIs), including immersive virtual reality (VR), exergaming, and mobile apps, may reduce these barriers.
To evaluate the efficacy of DMHIs in reducing depressive and anxiety symptoms among adults aged ≥ 50 years.
We conducted a PRISMA adherent systematic review and meta-analysis of randomized controlled trials. Interventions included immersive VR, exergaming/physical digital platforms, mobile applications, and digital cognitive training. Standardized mean differences (SMDs) were pooled with random effects models; heterogeneity was assessed with I 2.
Nineteen RCTs (n = 718; mean ages 50.9–84.7 years) met inclusion criteria. Across studies, DMHIs significantly reduced depressive symptoms (SMD = −0.656, 95% CI = −0.932 to −0.380; p < 0.001) and anxiety symptoms (SMD = −0.559, 95% CI = −0.740 to −0.380; p < 0.0001). Immersive and physically engaging modalities (e.g., VR, exergaming) outperformed app-based approaches. Heterogeneity ranged from moderate to high (I 2 ≈ 69.6%–97%).
Offer DMHIs: especially VR or exergaming when access to in-person therapy is limited or as an adjunct to usual care. Provide brief onboarding and, when feasible, caregiver support to boost adherence and confidence with technology. Select or configure age-friendly interfaces (e.g., large fonts, simple navigation) to address common usability barriers. Integrate DMHIs into stepped-care or rehabilitation pathways and monitor outcomes with validated tools (e.g., GDS, STAI). Address equity by supplying devices/connectivity solutions and consider cost-effectiveness and long-term engagement in implementation plans.
Trial Registration: PROSPERO ID: CRD420250655153
Non-communicable diseases (NCDs) are rapidly escalating in developing countries and social factors such as the dynamics of the family play an important part in the lifestyle choices that lead to the onset and maintenance of chronic illness. There remains a gap in Malaysia as the majority of the studies were focused on the normal population rather than directly towards persons having NCDs. This study aimed to examine emerging risk factors such as family functionality and its association with NCD.
A cross-sectional survey was conducted using a multistage random sampling method.
Urban residential areas in Selangor, Malaysia.
A total of 2542 adults residing in urban areas of Selangor were recruited.
Family functionality was measured using the APGAR (Adaptation, Participation, Gain or Growth, Affection and Resources) scale and multiple logistic regression was performed to measure the association between emerging risk factors and NCD.
The prevalence of diabetes mellitus and hypertension was 10.8% and 6.1%, respectively. Widowed/separated status (adjusted OR (AOR) 41.53, 95% CI 19.06 to 90.48, p value=0.001) was reported to be a predictor of diabetes. As for hypertension, familial functionality (AOR 4.2, 95% CI 1.11 to 14.50, p value
There is a growing concern that family functionality is an emerging risk factor for NCDs. Future family-centred health promotion programmes should be incorporated to improve self-management behaviours and health outcomes.
by Nurdiana Mohammad Hussin, Nik Ruzyanei Nik Jaafar, Idayu Badilla Idris, Azmawati Mohammed Nawi
Individuals with breast cancer (BC) experience significant psychological distress, yet their utilization of mental health services remains low. This study identified key factors influencing help-seeking behavior through integrated Theory of Planned Behavior (TPB) and Health Belief Model (HBM) frameworks. We conducted in-depth interviews (IDIs) with eight BC patients and nominal group technique (NGT) with six health professionals, followed by Fuzzy Delphi Method (FDM) to assess expert consensus. The IDIs revealed that the individuals with BC recognized the value of professional psychological support but were reluctant to engage with these services personally. The participants identified emotional thresholds for help-seeking, expressed preference for informal support networks, and demonstrated varied understanding of mental health professional roles. The FDM evaluation demonstrated strong expert consensus across all assessed elements, particularly those related to emotional support mechanisms. Three barrier categories emerged: individual factors (mental health literacy, autonomy preferences), social factors (family support, cultural stigma), and systemic factors (healthcare integration gaps). Expert consensus exceeded 80% agreement across all domains.This study identified a complex interplay between individual psychological barriers and systemic factors affecting mental health help-seeking among individuals with BC. Effective interventions must address psychological barriers and healthcare delivery factors while respecting individual autonomy in coping choices. A multi-level approach targeting individual education, family support systems, and healthcare integration is recommended to improve mental health service utilization among individuals with BC.The increasing incidence of type 2 diabetes mellitus (T2DM) among women of reproductive age poses significant health risks for both mothers and their fetuses. Optimising blood glucose levels during pregnancy is particularly challenging, even with a combination of oral antidiabetic agents and insulin therapy. Hydroxychloroquine (HCQ) has been shown to lower glucose levels in non-pregnant populations and has demonstrated safety in pregnant women with systemic lupus erythematosus and rheumatoid diseases. In addition to its glucose-lowering effects, HCQ also exhibits immunomodulatory, antioxidant and anti-inflammatory properties. Given that both T2DM and pregnancy are pro-inflammatory states, inadequate glycaemic control may exacerbate adverse pregnancy outcomes. We hypothesise that adjunctive treatment with HCQ in this cohort could improve glycaemic control, reduce systemic inflammation and subsequently lower the risk of adverse pregnancy outcomes.
This is a prospective, open-label, randomised controlled trial involving 56 pregnant women diagnosed with T2DM. Participants will be randomly allocated, using computerised randomisation software, into either a control group receiving standard care or an intervention group receiving standard care with HCQ 200 mg daily. The primary outcomes will be the difference in glycaemic parameters and inflammatory markers. Secondary outcomes include the assessment of pregnancy outcomes between the groups, such as gestational age at delivery, postpartum haemorrhage, fetal macrosomia and shoulder dystocia.
This protocol has been approved by the National University of Malaysia Ethics Committee (JEP-2023–866). Study findings will be disseminated via presentations at academic conferences, publications in peer-reviewed journals and professional training and meetings to healthcare professionals.
This study was registered in ClinicalTrials.gov (NCT06319560) on 23 January 2024.
by Osman Yimer Mohammed, Kerstin Erlandsson, Tewodros Seyoum, Solomon Hailemeskel, Lemma Derseh, Helena Lindgren
BackgroundWork-related musculoskeletal disorder is a limiting, painful condition that affects the muscular, skeletal, articular, and nervous tissues of the body. The condition is mainly associated with poor working conditions and awkward body positions. Health professionals, including midwives, are among the most affected workforce globally. The condition affects the health of the professionals and the quality of care that professionals are expected to provide. However, there is a scarcity of information on the magnitude of the condition, its effect on midwifery practice, and associated factors. Objectives: This study aimed to assess the magnitude of work-related musculoskeletal disorder, its effect on midwifery practice, and associated factors among midwives in North Shoa Zone, Amhara Regional State, Ethiopia.
MethodAn institution-based cross-sectional study assessed the magnitude of work-related musculoskeletal disorder (WRMSD), the effect on midwifery practice, and associated factors. The Nordic Musculoskeletal Disorder Scale was used to assess the presence of WRMSDs in the nine regional body parts and its effect. A stepwise backward elimination logistic regression model was used, and significant association was declared at a p-value of less than 0.05.
ResultsA total of 473 (252 (53.3%) female and 221 (46.7%) male) midwives participated in this study. Overall, in the last 12 months, 355 (75.05%, 95% CI: 71.15% − 78.95%) midwives were affected by WRMSD, which was seen in any one of the nine regional body parts. About 45% (162) of them reported being unable to perform their daily tasks while they were affected, and 27% (96) of them sought treatment for their condition. The lower back was the most affected axial body part, reported by 300 (63.4%, 95% CI: 59% − 68%) midwives. Working in awkward or uncomfortable positions was significantly associated with the development of WRMSD (AOR: 1.81, 95% CI: 1.15–2.87). Similarly, awkward positions significantly affected the development of area-specific WRMSD in the lower back, upper back, neck, and limbs. Working in the same position for a longer time, seeing clients daily, and moving heavy objects were among the risk factors associated with developing area-specific WRMSD among midwives.
ConclusionThe magnitude of work-related musculoskeletal disorders is high among midwives, and a significant number of them were unable to perform their daily tasks. The lower and upper back are the most commonly affected areas. Working in uncomfortable positions and attending to large clients daily were common risk factors. Therefore, training midwives about safe working positions and reducing the workload is commendable.
by Abdullah M. Aldhaif, Mohammed A. Al-Garni, Ahmed A. Muyidi, Mohammed H. Makkawi
BackgroundClostridioides difficile infection (CDI) remains a major healthcare-associated infection with limited contemporary data from Saudi Arabia. This study evaluated CDI prevalence, risk factors, recurrence predictors, and treatment patterns in hospitalized patients at a tertiary teaching hospital.
MethodsRetrospective analysis of 1,054 hospitalized patients screened between March 2023 and February 2024. CDI was confirmed by positive toxin assay and/or nucleic acid amplification test (NAAT). Demographic, clinical, antibiotic, acid-suppressant, and treatment data were collected. Bivariate associations and multivariable logistic regression were used to identify predictors of recurrence.
ResultsCDI prevalence was 10.8% (114/1,054). Median age was 37 years (IQR 51.25); 32.5% had malignancy. Antibiotic exposure preceded CDI in 59.6% (meropenem 24.7%, ceftriaxone 16.5% of courses), and acid suppressants were used in 57.0% (omeprazole 92.3%). Recurrence occurred in 11.4% (13/114). On bivariate analysis, acid-suppressant use was significantly associated with recurrence (p = 0.041). In multivariable logistic regression, only metronidazole plus vancomycin combination therapy independently predicted recurrence (OR 11.29, 95% CI 1.13–112.42, p = 0.039). Trends were observed for malignancy (OR 2.94, p = 0.112) and acid-suppressant use (OR 1.85, p = 0.440), limited by the small number of recurrent events. Metronidazole monotherapy dominated treatment (64.8%).
ConclusionCDI prevalence reached 10.8% with an 11.4% recurrence rate. Acid-suppressant exposure and combination therapy were key recurrence signals, while metronidazole remains overused despite international guideline shifts. Enhanced antibiotic and acid-suppressant stewardship, alongside improved access to guideline-recommended therapies, are critical to reducing CDI burden in Saudi tertiary hospitals.
To assess the effectiveness of fresh frozen plasma (FFP) as an adjunctive treatment to anti-snake venom (ASV) for resolving venom-induced consumption coagulopathy (VICC) in patients with hemotoxic snakebites.
Systematic review and meta-analysis, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
MEDLINE, ScienceDirect, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Europe PubMed Central, Directory of Open Access Journals, Google Scholar, ClinicalTrials.gov and WHO ICTRP were searched from inception to 30 July 2025 using multiple terms, including ‘fresh frozen plasma’, ‘plasma transfusion’, ‘hemotoxic snakebite’, ‘vasculotoxic snakebite’, ‘coagulopathy in snake bite’ and ‘venom-induced consumption coagulopathy’.
We included randomised controlled trials and observational studies in the English language comparing antivenom alone with antivenom with FFP in patients with hemotoxic snakebite-induced coagulopathy. Studies must have reported coagulopathy resolution as measured by international normalised ratio (INR) normalisation or 20 min whole blood clotting test (WBCT) correction. Non-English publications, case reports, case series, reviews, conference abstracts, preclinical studies and studies lacking full-text availability or without quantitative INR or WBCT outcome data were excluded.
Two independent reviewers extracted data using standardised extraction forms and assessed risk of bias using the Cochrane Risk of Bias 2 tool for randomised controlled trials and the Newcastle–Ottawa scale for observational studies. Data were pooled using random-effects meta-analysis and expressed as ORs with 95% CIs. Statistical heterogeneity was assessed using I² statistics, and the certainty of evidence was evaluated using the Grades of Recommendation, Assessment, Development and Evaluation approach.
Four studies involving 370 patients were included (two randomised controlled trials and two prospective observational studies). The pooled analysis demonstrated that adjunctive FFP significantly increased the likelihood of coagulopathy resolution compared with antivenom alone (OR=7.71, 95% CI 2.20 to 27.04, p=0.001). No evidence of a significant difference in mortality was observed between groups (OR=4.96, 95% CI 0.55 to 44.60, p=0.15). High heterogeneity was noted among the four studies (I² = 67%), but a subgroup analysis of three studies, which used INR as the outcome assessment method, showed lower heterogeneity (I² = 25%). Adverse events were inconsistently reported across studies.
FFP as an adjunct to antivenom significantly improves coagulopathy resolution in patients with hemotoxic snakebite-induced coagulopathy. However, the certainty of evidence is very low because of methodological limitations, small sample sizes and significant heterogeneity. Although FFP shows promise for rapid coagulopathy correction, mortality benefits are not established, and it should not replace timely antivenom administration or comprehensive supportive care.
PROSPERO, CRD42023483336.
by Darren Curnoe, Mohammed S. Sauffi, Hsiao Mei Goh, Xue-feng Sun, Roshan Peiris
The rarity of Late Pleistocene hominin remains from Insular Southeast Asia (ISEA) has hampered our ability to understand a crucial episode of human evolutionary history, namely, the global dispersal of Homo sapiens from Africa. Moreover, recent discoveries indicate a surprising level of taxic diversity during this time with at least two species—H. floresiensis and H. luzonensis—endemic to the region when H. sapiens first arrived. A third hominin dubbed the ‘Denisovans’ is shown from DNA evidence to have interbred with the ancestors of contemporary Indigenous populations across ISEA, New Guinea and Australia. Yet, the Denisovans have not been identified from the fossil record of the area despite recent breakthroughs in this regard on mainland East Asia. New excavations by our team at the Trader’s Cave in the Niah National Park (‘Niah Caves’), northern Borneo, have yielded an isolated hominin upper central permanent incisor dated with Optically Stimulated Luminescence dating of sediments to about 52 − 55 thousand years ago. Specimen SMD-TC-AA210 has a massive crown absolutely and relative to its root size, the crown is wide (mesiodistally) and relatively short (labiolingually). Morphologically, it exhibits a very strong degree of labial convexity, pronounced shovelling, and the bulging basal eminence exhibits several upward finger-like projections. Labial enamel wrinking on the enamel-dentine junction is expressed as two large ridges exhibiting numerous spine-like projections, and the lingual extensions on the enamel surface of the basal eminence are expressed as six extensions. This combination of crown size and morphological traits is not normally found in H. sapiens and instead characterises archaic members of Homo such as H. erectus, H. neanderthalensis and Middle Pleistocene hominins sharing a clade with H. heidelbergensis. The Trader’s Cave tooth suggests that an archaic hominin population inhabited northern Borneo just prior to or coincident with the arrival of H. sapiens as documented at the nearby West Mouth of the Niah Great Cave.To assess the relationship between paradoxical leadership and nurses' positive attitudes towards artificial intelligence in hospital settings through a strengths mindset as a mediator.
A cross-sectional survey conducted from January to March 2024.
The study included 239 nurses from four hospitals in Port Said, Egypt. To measure the study constructs, three well-established scales were utilised: the Paradoxical Leadership Scale, the Strengths Mindset Scale and the Positive Attitudes Towards Artificial Intelligence Scale. Structural equation modelling was applied for data analysis.
The analysis revealed a significant positive relationship between nurse managers' paradoxical leadership and nurses' positive attitudes towards artificial intelligence. Additionally, a strengths mindset partially mediated the relationship between paradoxical leadership and nurses' positive attitudes towards artificial intelligence.
The study findings suggest that developing paradoxical leadership behaviours—such as managing current work processes while simultaneously driving the exploration of new initiatives—among nurse managers can foster a strengths mindset in nurses, which in turn promotes a more positive attitude towards the integration of artificial intelligence in healthcare.
This study enhances the understanding of how paradoxical leadership influences nurses' acceptance of artificial intelligence, underscoring the pivotal role of a strengths mindset in this process.
This study suggests that healthcare policymakers seeking smoother integration of artificial intelligence technologies among nurses should prioritise leadership development programmes that equip nurse managers with paradoxical leadership skills and implement training initiatives to strengthen nurses' mindsets.
The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
No patient or public contribution.
To evaluate the effects of diabetes mellitus (DM) and body mass index (BMI) on long-term all-cause mortality in chronic total occlusion (CTO) patients.
Retrospective, nationwide cohort study.
Swedish Coronary Angiography and Angioplasty Registry, between June 2015 and December 2021.
24 284 patients with angiographically confirmed CTO. Prior coronary artery bypass graft surgery excluded. Subgroups were defined by DM status and BMI categories (underweight, healthy weight, overweight, obesity).
Long-term all-cause mortality, assessed by Kaplan-Meier analysis and multivariable Cox proportional hazards regression.
DM was present in 30.3% of patients and conferred a 31% higher risk of mortality (HR: 1.31, 95% CI: 1.20 to 1.42; p2, lowest risk (nadir) at 32 kg/m2 and modest rise above 35 kg/m2.
In this nationwide CTO cohort, DM independently predicted higher long-term mortality, accompanied by more severe comorbidities and greater CTO complexity, and insulin therapy further elevated hazard. Overweight and obese patients had better survival, while underweight individuals had the poorest prognosis. These findings underscore the importance of individualised risk assessment and management strategies in CTO patients, particularly those with DM or low BMI.
Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analytics, offer significant potential to impact nursing practice and patient outcomes.
This systematic review aims to assess the impact of Artificial Intelligence applications in healthcare on nursing practice and patient outcomes. The goal is to evaluate the effectiveness of these technologies in improving nursing efficiency and patient care and to identify areas requiring further research.
This review, conducted in August 2024, followed PRISMA guidelines. We searched PubMed, GOOGLE SCHOLAR, and Web of Science for studies published up to August 2024. The inclusion criteria were original research on AI in nursing and healthcare practice published in English. A two-stage screening process was used to select relevant studies, which were then analyzed for their impact on nursing practice and patient outcomes.
A total of 5975 studies were surveyed from the previously mentioned databases, which met the inclusion criteria. Findings show that AI applications, including machine learning, robotic process automation, and natural language processing, have improved diagnostic accuracy, patient management, and operational efficiency. Machine learning enhanced disease detection, reduced administrative tasks for nurses, NLP improved documentation accuracy, and physical robots increased patient safety and comfort. Challenges identified include data privacy concerns, integration into existing workflows, and methodological variability.
AI technologies have substantially improved nursing practice and patient outcomes. Addressing challenges related to data privacy and integration, as well as standardizing methodologies, is essential for optimizing AI's potential in healthcare. Further research is needed to explore the long-term impacts, cost-effectiveness, and ethical implications of Artificial Intelligence in this field.
Artificial Intelligence (AI) is revolutionizing healthcare by enhancing nursing practices and improving patient outcomes. Tools such as Clinical Decision Support Systems (CDSS), predictive analytics, robotic process automation (RPA), and remote monitoring empower nurses to make informed decisions, optimize workflows, and monitor patients more effectively. AI enhances decision-making, boosts efficiency, and facilitates personalized care, while aiding in early detection and real-time data analysis. It also contributes to better nurse education and patient safety by minimizing errors and enabling remote consultations. However, for AI to be successfully integrated into healthcare, it is essential to tackle challenges related to training, ethical considerations, and data privacy to guarantee its effective implementation and positive impact on the quality and safety of healthcare.
FreshRSS 