Nevin Manimala

J Community Health Nurs. 2026 Mar 1:1-9. doi: 10.1080/07370016.2026.2636641. Online ahead of print.

ABSTRACT

PURPOSE: To examine recent trends, disparities, and geographic variation in US mortality rates using National Center for Health Statistics (NCHS) Vital Statistics Rapid Release (VSRR) provisional estimates from 2022 through 2024, with attention to ongoing effects of COVID-19 and implications for public health planning.

DESIGN: Secondary analysis of nationally reported quarterly mortality data using a quantitative, descriptive epidemiological approach.

METHODS: Quarterly provisional mortality estimates were obtained from NCHS VSRR and supplemented with demographic and geographic data from CDC WONDER and COVID-19 mortality reports. Publicly available data required no institutional approval. Temporal trends were assessed from 2022 Q1 through 2024 Q3. Mortality rates were analyzed by sex and by state to identify demographic and regional disparities. Post-pandemic patterns were evaluated to assess indirect effects of COVID-19.

FINDINGS: Overall mortality declined from early 2022 through mid-2023, followed by a resurgence in 2024. Male mortality remained higher than female mortality across all quarters. Geographic disparities persisted, with elevated mortality concentrated in Appalachian and Southern states and lower rates in states with stronger healthcare infrastructure. The 2024 increase suggests continued vulnerability related to delayed chronic disease management, behavioral health challenges, and residual pandemic disruptions.

CONCLUSIONS: Although mortality declined after the acute phase of COVID-19, the 2024 rebound highlights ongoing health system strain and persistent inequities across the US.

CLINICAL RELEVANCE: Findings support targeted prevention, chronic disease monitoring, and equity-focused interventions to reduce post-pandemic mortality disparities and improve population health outcomes.

PMID:41766057 | DOI:10.1080/07370016.2026.2636641

J Clin Ultrasound. 2026 Mar 1. doi: 10.1002/jcu.70217. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this research was to quantitatively evaluate the vascular supply and tissue stiffness of the salivary glands-namely, the submandibular and parotid glands-in pregnant individuals throughout the three trimesters, employing superb microvascular imaging (SMI) and shear wave elastography (SWE).

METHODS: A longitudinal prospective study was executed involving 35 healthy pregnant women. Salivary gland ultrasonography was conducted during each trimester. The vascularization index (VI) was quantified using the two-dimensional SMI VI (2DcSMIVI) mode by manually delineating the glandular parenchyma. Glandular elasticity was measured through SWE in kilopascals (kPa) and meters per second (m/s). Statistical evaluations incorporated repeated measures ANOVA and the Friedman test (p < 0.05).

RESULTS: Submandibular gland stiffness showed significant trimester-based variations, with kPa values peaking in the second trimester and declining in the third (F(2,68) = 5.31, p < 0.05, η² = 0.13). Likewise, m/s values were elevated in the second trimester relative to the third (X² = 7.79, p < 0.05). In contrast, the stiffness and VI values of the parotid gland exhibited consistency across trimesters (p > 0.05).

CONCLUSION: The dynamic shifts in submandibular gland stiffness, highlighted by a rise in the second trimester followed by a decrease in the third, most likely signify the hormonal and hemodynamic adaptations that come with pregnancy. These findings underscore the importance of monitoring salivary gland function in pregnant women and pave the way for future investigations into the diagnostic and prognostic implications of these changes. To the best of our knowledge, this represents the inaugural study demonstrating normative stiffness and vascularity parameters of salivary glands across each trimester of pregnancy.

PMID:41766051 | DOI:10.1002/jcu.70217

Sci Rep. 2026 Mar 1. doi: 10.1038/s41598-026-41905-5. Online ahead of print.

ABSTRACT

Globally, road traffic injuries (RTIs) cause numerous tragedies such as serious economic loss to the community and death of young people. In Ethiopia, a large proportion of serious injuries result from RTIs and have become major causes of death in hospitals. However, there is insufficient research conducted on treatment outcomes of road traffic injuries and associated factors in the study area. The primary aim of this study was to determine the magnitude of poor treatment outcomes and identify associated factors among patients in the emergency departments of public hospitals in Awi Zone, Northwest Ethiopia. A facility-based cross-sectional study was employed in Awi Zone public hospitals, northwest Ethiopia. With a sample of Medical charts of 461 RTI patients were reviewed and data were collected between January 1, 2022 and June 30, 2024. Data were collected by using data collection checklist. Four nurses and one health officer were employed as data collector and supervisor respectively. Data were entered using Epi Data version 4.7 and cleaned, coded, and analyzed using SPSS version 27. Bivariate analysis was computed and variables with p-value < 0.25 were included in multi-variable logistic regression. The significant of statistical associations were tested using odds ratio and 95% confidence interval (CI) and p-value < 0.05. Finally, the results were presented in texts, tables, and graphs. For this study, 461 study subjects of RTIs victims were enrolled. Among these, 49 (10.6%) patients had poor treatment outcomes. Patients aged 31-50 years [AOR = 0.091, 95% CI: 0.019-0.443], patient age > 50 years [AOR = 0.114, 95% CI: 0.021-0.606], absence of complication [AOR: 0.021; CI: (0.002-0.208)], and patients who received first aid [AOR: 0.340; CI: (0.123-0.938)] were significantly associated with poor treatment outcomes. The study showed a high rate of prognosis but still the poor outcome was not underestimated. Age, absence of complications, and first aid service were statistically significant factors that affect treatment outcomes. Therefore, health care providers should prioritize those RTI victims with complication, not received first aid service, and younger age groups.

PMID:41766044 | DOI:10.1038/s41598-026-41905-5

BMC Med Res Methodol. 2026 Mar 2. doi: 10.1186/s12874-026-02813-4. Online ahead of print.

NO ABSTRACT

PMID:41765962 | DOI:10.1186/s12874-026-02813-4

Transl Psychiatry. 2026 Mar 2. doi: 10.1038/s41398-026-03857-2. Online ahead of print.

ABSTRACT

Working memory (WM) deficits are commonly observed across the depression spectrum and may represent a modifiable cognitive mechanism. This systematic review and meta-analysis evaluated the effects of WM training (WMT) on depressive symptoms and WM performance, and examined potential moderators and the association between WM gains and symptom change. Systematic searches of PsycINFO, Embase, and PubMed were conducted in December 2022 and updated in January 2025. Eligible studies were randomized controlled trials (RCTs) using WMT as the sole cognitive intervention with depressive symptoms as outcomes. Two-level random-effects models were used for depressive symptoms and three-level models for WM outcomes. Risk of bias was assessed by the Cochrane Risk of Bias Tool. Twenty-seven RCTs involving 1692 participants were included. WMT produced a small but significant reduction in depressive symptoms at post-training (Hedges’ g = 0.20, 95% CI [0.04, 0.35]), though effect was not maintained at follow-up. Moderate improvements in WM were observed at post-training (g = 0.61, 95% CI [0.24, 0.98]) and follow-up (g = 0.72, 95% CI [0.07, 1.38]). Post-training WM gains were positively associated with symptom reductions at follow-up. Moderator analyses indicated that baseline symptom severity and training material valence may influence outcomes, though subgroup effects were not statistically significant and warrant cautious interpretation. These findings suggest that WMT targets a potentially modifiable mechanism in depression, but its clinical utility remains uncertain. Larger RCTs, particularly in clinical populations and with extended follow-ups, are needed to establish more definitive evidence regarding its preventive and therapeutic value. (Protocol registration: PROSPERO, CRD42023400213.).

PMID:41765936 | DOI:10.1038/s41398-026-03857-2

Sci Rep. 2026 Mar 1. doi: 10.1038/s41598-026-39157-4. Online ahead of print.

ABSTRACT

The structure of the soil bacterial community is crucial for maintaining ecosystem balance and facilitating material transformation in mangrove ecosystems. The large-scale destruction of mangroves directly impacts soil bacterial processes, potentially leading to ecosystem degradation. This study employed Illumina NovaSeq high-throughput sequencing to investigate the rhizosphere bacterial community of Kandelia obovata seedlings in both natural and artificially restored forests. Although alpha and beta diversity analyses revealed that the overall bacterial community structure was not significantly altered by artificial restoration, significant shifts in the abundance of specific bacterial genera were identified. A substantial proportion (86.1%-92.6%) of bacterial sequences remained unclassified at the genus level. Distinct dominant genera were observed across different groups: the well-grown artificial group (treat-k) was enriched with Sulfurovum, Actibacter, and Desulfatiglans (5.09%, 2.18%, and 1.82%, respectively), while the poorly-grown artificial group (treat-s) was characterized by Ignavibacterium, Prolixibacter, and Woeseia (2.10%, 1.21%, and 1.06%, respectively). The natural group was dominated by Woeseia, Desulfatiglans, and Halioglobus (1.56%, 1.53%, and 1.11%). Statistical analysis further confirmed that the abundance of several genera, including Ignavibacterium, Prolixibacter, and Haliangium differed significantly (p < 0.05) between the poorly-grown group (treat-s) and the better-grown groups (treat-k and natural). In conclusion, while artificial restoration did not restructure the rhizosphere bacterial community at a global level, it selectively shaped the microbial assemblage by enriching specific bacterial taxa, which might play a crucial role in determining the growth status of Kandelia obovata during restoration.

PMID:41765934 | DOI:10.1038/s41598-026-39157-4

Confl Health. 2026 Mar 1. doi: 10.1186/s13031-026-00777-2. Online ahead of print.

ABSTRACT

BACKGROUND: In Somalia, a fragile state characterized by protracted conflict and fragmented health governance, childhood immunization remains a critical challenge. The third dose of the Diphtheria-Tetanus-Pertussis (DTP3) vaccine serves as a key indicator of health system performance and retention. This study aimed to identify structural and individual-level determinants of DTP3 coverage to understand the inequities in this humanitarian setting.

METHODS: A cross-sectional analysis was conducted using data from the 2020 Somali Health and Demographic Survey (SHDS). A total sample of 1,268 children was analyzed. Multilevel mixed-effects logistic regression models were fitted to account for the hierarchical structure of the data (children nested within communities). Fixed effects were reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

RESULTS: The overall prevalence of DTP3 vaccination coverage was 39.51% [95% CI: 36.85-42.23]. At the individual level, higher maternal education (Secondary vs. no education: aOR = 1.83; 95% CI: 1.07-3.12), wealth status (Rich vs. poor: aOR = 2.41; 95% CI: 1.53-3.79), and antenatal care (ANC) attendance (3-4 visits vs. zero visits: aOR = 2.19; 95% CI: 1.43-3.36) were significantly associated with higher odds of vaccination. Older children had higher odds of vaccination compared to infants, suggesting delayed rather than timely uptake. At the community level, children in rural (aOR = 0.40; 95% CI: 0.28-0.57) and urban (aOR = 0.64; 95% CI: 0.45-0.91) areas had lower odds of vaccination compared to those in nomadic communities. Significant regional disparities were also observed.

CONCLUSIONS: DTP3 coverage in Somalia is critically below the WHO 90% target. Vaccination status is shaped by a complex interplay of socioeconomic status, maternal healthcare utilization, and geographic location. Policy interventions must urgently address the ‘urban penalty’ identified in this study, where settled urban-poor populations now face lower odds of vaccination than nomadic groups targeted by mobile outreach.

PMID:41765923 | DOI:10.1186/s13031-026-00777-2

BMC Public Health. 2026 Mar 2. doi: 10.1186/s12889-025-25689-3. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiometabolic diseases (CMDs), including cardiovascular diseases (CVD), type 2 diabetes mellitus (T2DM), and metabolic syndrome, are major global health concerns. In Hungary, CVD mortality remains above the OECD average, and diabetes prevalence is increasing. This study examines the association between sociodemographic and lifestyle factors and the risk of CMDs among Hungarian adults, using population-based data collected between 2009 and 2019.

METHODS: A repeated cross-sectional design was used to analyze data from the European Health Interview Survey (EHIS) in Hungary for the years 2009, 2014, and 2019 (n = 16,480). CMD was defined as self-reported diagnosis of both CVD and diabetes. Weighted proportions, Pearson’s chi-squared tests, and multiple binary logistic regression models were applied to identify associations between CMD and sociodemographic (sex, age, education, employment, income, residence), behavioral (BMI, smoking, alcohol use), and clinical risk factors (hypertension, hypercholesterolemia). Predicted probabilities were estimated using marginal effects.

RESULTS: Prevalence of CMD fell by 27% in 2019 (OR = 0.73 [0.57-0.94], P = 0.013), with predicted probability declining from 5.6% to 4.1%. Younger age (< 35: OR = 0.01, P < 0.001; 35-64: OR = 0.68, P = 0.002), female sex (OR = 0.65, P < 0.001), and employment (OR = 0.32, P < 0.001) were protective. CMD risk was higher in urban areas (OR = 1.44, P = 0.048), alcohol users (OR = 1.35, P = 0.004), those with hypertension (OR = 3.83, P < 0.001), hypercholesterolemia (OR = 3.10, P < 0.001), mental illness (OR = 1.49, P = 0.027), and depression (OR = 1.63, P = 0.001). Normal BMI reduced risk (OR = 0.48, P < 0.001).

CONCLUSION: The prevalence of CMD in Hungary decreased between 2009 and 2019, indicating progress in prevention and risk factor management. However, disparities persist among older adults, men, and urban residents. Targeted screening, lifestyle interventions, and mental health support are essential to strengthen the management of cardiometabolic diseases.

PMID:41765912 | DOI:10.1186/s12889-025-25689-3

Syst Rev. 2026 Mar 2. doi: 10.1186/s13643-026-03105-0. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic low back pain (CLBP) is among the most disabling musculoskeletal disorders worldwide. Traditional in-person rehabilitation is often limited by time, geographic, and financial barriers. Telerehabilitation, which delivers personalized interventions through digital technologies (e.g., mobile apps, video coaching, wearable devices, virtual reality, and artificial intelligence feedback systems), is emerging as a complementary and alternative approach to conventional rehabilitation. However, there is currently no consensus on its efficacy and safety. Therefore, this study aims to evaluate the effectiveness of various forms of telerehabilitation in improving pain intensity, physical function, psychological symptoms, and quality of life in patients with CLBP. In addition, the study will assess intervention adherence, patient satisfaction, and safety (as measured by the incidence of adverse events) through systematic review and network meta-analysis.

METHODS: A systematic search will be conducted in the following databases: PubMed/MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science, covering all records from database inception to 31 December 2025. Eligible studies will include randomized controlled trials (RCTs) involving adults (≥ 18 years) with CLBP, comparing telerehabilitation interventions to any control intervention. The primary outcome will be pain intensity, while secondary outcomes will include physical function, psychological status, quality of life, and adverse events. The risk of bias for the included studies will be assessed using the revised Cochrane Risk of Bias 2.0 tool. The certainty of evidence will be evaluated using the CINeMA (Confidence in Network Meta-Analysis) web application. All network meta-analyses will be conducted within a frequentist framework using Stata 15 software and will apply random-effects models. Intervention rankings will be estimated using Surface Under the Cumulative Ranking (SUCRA) curves and illustrated with forest plots showing both individual and pooled effect sizes. Additional analyses will include assessments of statistical inconsistency, publication bias, heterogeneity, sensitivity, and subgroup differences.

DISCUSSION: This study aimed to compare and rank the available evidence on various forms of telerehabilitation for the management of CLBP, as well as to assess its safety. The findings offer valuable insights for healthcare professionals and policymakers, supporting the advancement of patient-centered rehabilitation strategies.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251015478.

PMID:41765905 | DOI:10.1186/s13643-026-03105-0

J Orthop Surg Res. 2026 Mar 1. doi: 10.1186/s13018-026-06768-6. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the epidemiological characteristics and anatomical distribution of stress fractures (SFs) in a pediatric and adolescent population over an eight-year period.

METHODS: We conducted a retrospective cohort study at a tertiary care orthopedic center. We reviewed medical records and imaging data for patients aged 6-18 years who were diagnosed with SFs between January 2017 and December 2024. Patients were assigned to age groups of 6-11, 12-15, and 16-18 years. We collected demographic data, fracture location, and annual consultation-based rates. Statistical analyses were performed using SPSS 26.0 and R software for trend analysis.

RESULTS: A total of 726 patients (403 males, 323 females; median age 14 years, IQR 12-15) were included. The overall consultation-based rate was 23.20 per 100,000 unique pediatric orthopedic patients. Cases were concentrated in the 12-15 years age group, which accounted for 78.24%. The tibia was the most commonly involved bone (83.06%), and the proximal tibia was the single most frequent site (48.62%). Annual rates rose from 8.09 per 100,000 in 2017 to a peak of 38.98 in 2022, then declined to 23.98 in 2024(Poisson regression for linear trend, P < 0.001). Male patients had a higher proportion of proximal tibia fractures, whereas female patients had more mid- to distal-tibia fractures (P < 0.01).

CONCLUSIONS: SFs predominantly affected adolescent males, and the proximal tibia was the most vulnerable site. The observed rise-and-fall trend temporally coincided with shifts in educational and physical activity policies in China, although causal inference was limited by the ecological study design. These descriptive findings emphasized the need for prospective studies that incorporate exposure and risk-factor assessment to inform targeted prevention strategies.

PMID:41765889 | DOI:10.1186/s13018-026-06768-6