Nevin Manimala

Environ Monit Assess. 2026 Mar 22;198(4):340. doi: 10.1007/s10661-026-15150-2.

ABSTRACT

This study evaluated the water quality of the Rio do Campo watershed, located in the municipality of Campo Mourão, Paraná State, through the analysis of physicochemical parameters and the quantification of total concentrations of trace metals (Cu, Zn, Mn, and Fe) using atomic spectrometry procedures following the Standard Methods for the Examination of Water and Wastewater (24th ed.). Sampling was carried out at five points with different land uses and occupations, in urban and rural areas, over a 6-month period. Data were summarized using median values and analyzed using non-parametric statistical approaches. The results indicated statistically significant differences between rural and urban areas, with higher trace metal concentrations and turbidity at urban sites, attributed to the input of effluents and increased surface runoff. Parameters such as pH, BOD, COD, and DO exhibited variation consistent with the land-use gradient. Principal component analysis revealed overlap among rural, urban, and intermediate sites, indicating the presence of a continuous environmental gradient along the basin. All concentrations remained within the limits established by CONAMA Resolution No. 357/(Tundisi 2005). Nevertheless, the observed spatial distribution reinforces that the system is sensitive to local anthropogenic pressures, particularly in urbanized sections, highlighting the need for continuous monitoring to prevent potential future changes in water quality.

PMID:41865220 | DOI:10.1007/s10661-026-15150-2

J Cancer Educ. 2026 Mar 21. doi: 10.1007/s13187-026-02857-6. Online ahead of print.

ABSTRACT

OBJECTIVES: As future practitioners, health profession students play a vital role in vaccination efforts. We sought to assess the impact of a longitudinal community-based program on health professional students’ knowledge and self-confidence to provide accurate, evidence-based resources to patients and address vaccination hesitancy.

STUDY DESIGN: Retrospective cohort study.

METHODS: In 2023, 181 interprofessional health profession students participated in an asynchronous didactic curriculum designed to educate health profession students in their last two years of clinical training on how to provide vaccine education and address vaccine hesitancy.

RESULTS: The data analysis revealed a statistically significant positive change between the pre-test and post-test phases regarding students’ self-reported understanding of the human papillomavirus (HPV) vaccine and addressing vaccine hesitancy. The qualitative feedback from participants expressed an appreciation for the didactic content and provided feedback that identified the videos embedded into the curriculum as engaging.

CONCLUSION: The results of this project demonstrated that targeted education on vaccine-related issues, and vaccine hesitancy can effectively increase health profession students’ knowledge and willingness to engage in public health efforts. The findings suggest a need for future curricular efforts to address complex health issues such as like parent-provider communication around vaccines and addressing vaccine hesitancy beyond HPV.

PMID:41865218 | DOI:10.1007/s13187-026-02857-6

Support Care Cancer. 2026 Mar 22;34(4):350. doi: 10.1007/s00520-026-10586-1.

ABSTRACT

PURPOSE: To inform development of centralised, evidence-based clinical trials resources for Australians with ovarian cancer, a structured understanding of knowledge gaps and resource needs was essential. The study aimed to assist resource development by assessing awareness, information access, and participation in clinical trials of ovarian cancer patients.

METHODS: A national, cross-sectional online survey among Australians with ovarian cancer was conducted between October and November 2024. Descriptive and inferential statistics along with qualitative content analyses were conducted. Associations were examined using Chi-Square and Fisher Exact tests.

RESULTS: Surveys from 272 respondents indicated moderate knowledge ( $\overline{x}$ = 4.46/10, SD = 2.34) and a high perception of importance of clinical trials ( $\overline{x}$ = 9.27/10, SD = 1.17). 56% of respondents reported not receiving clinical trials information and 44% had sought information themselves. Respondents preferred information by email newsletter (34%), through health professional discussions (20%) and accessing an online information hub (17%). Information access enablers included clinicians being knowledgeable about clinical trials, personalised discussions, and access to a centralised information source. Barriers included fragmented information across websites, use of complex medical language and competing responsibilities as caregivers. A qualitative analysis of open-ended responses (n = 96) revealed three core themes: ‘we need better solutions to help find information and participate in clinical trials’, ‘weighing up options’ in their decision to participate, and ‘we want to help improve outcomes for women in the future’.

CONCLUSIONS: Results from this study of Australians with ovarian cancer inform actionable change through development of evidence-based, tailored resources. Further solutions and evaluation of intervention effectiveness will continue through sector collaboration.

PMID:41865188 | DOI:10.1007/s00520-026-10586-1

Sci Rep. 2026 Mar 22. doi: 10.1038/s41598-026-45235-4. Online ahead of print.

ABSTRACT

The reasonable delay time setting is the key factor affecting the blasting effect of gas tunnel. To this end, we have introduced a digital electronic detonator that can be freely set on site. Through theoretical analysis, we obtained the time required for the rock mass to be completely thrown out in the cutting area, revealed the law of rock mass movement by numerical simulation, and further proposed a blasting effect evaluation method and carried out engineering application. The results show that the optimal initiation time of the cutting area is 40ms, and the migration law of rock mass can be divided into three stages: crack propagation, volume increase and rock mass ejection. According to the optimal delay time in the cutting area, the optimal initiation time between each row of blast holes was determined to be 0ms, 40ms, 60ms, 80ms, 100ms, and 120ms, respectively, and a blasting effect evaluation system including blasting effect index K and circumferential flatness σ was established. Finally, a field test was carried out in a plateau gas tunnel. The statistical characteristics of the blasting effect show that after optimizing the delay time, the half-hole rate after blasting is above 90%, the linear average over-excavation is within 20 cm, and the circumferential flatness σ is 2.9 cm. The contour control accuracy is high, and the particle size distribution of the blasting pile is reasonable, which provides a reference for similar engineering blasting.

PMID:41865184 | DOI:10.1038/s41598-026-45235-4

Sci Rep. 2026 Mar 22. doi: 10.1038/s41598-026-44452-1. Online ahead of print.

ABSTRACT

This study examines how shared leadership (SL) is associated with civil servants’ voice behavior (VB), focusing on indirect pathways via psychological capital (PsyCap) and organizational identification (OI). In a single-wave cross-sectional survey of 440 Chinese civil servants, SL was positively associated with PsyCap and OI. In turn, both factors were associated with higher levels of both promotive voice behavior (PVB) and prohibitive voice behavior (PRVB). Furthermore, SL showed indirect associations with VB through these psychological factors, underscoring the relevance of employees’ psychological resources and OI in leadership-voice relationships. Importantly, these relationships reflect statistical associations rather than direct causal effects. By elucidating how SL relates to VB through these psychological pathways, this study contributes to a more integrated understanding of leadership and voice in organizational research. The findings also offer context-specific implications for leadership development and organizational management in public-sector settings.

PMID:41865174 | DOI:10.1038/s41598-026-44452-1

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-44604-3. Online ahead of print.

ABSTRACT

Comorbid diseases are complex diseases associated with tuberculosis that may affect tuberculosis treatment outcomes and mortality. The impact of comorbid diseases on tuberculosis treatment outcomes and mortality is not well known in Ethiopia. To assess the impact of comorbid diseases and associated factors on tuberculosis treatment outcomes among tuberculosis patients in Southwest Oromia, Ethiopia. A multicenter retrospective cohort study was performed. Information on sociodemographic, clinical conditions, drug-related factors, and treatment outcomes was extracted. The collected data were entered into Epi-Data version 4.6 for data entry and exported to SPSS version 25 (IBM Corp., Armonk, NY, USA) for statistical analysis. Independent t-tests were used for continuous variables and chi-square for categorical variables for comparison of the tuberculosis patients with and without comorbid disease groups. Univariate and multivariate logistic regression were used for outcomes analysis. Statistical significance was determined at a p-value < 0.05 in multivariate logistic regression. Among a total of 1183 tuberculosis patients, females were 825(69.8%), and the mean age of the patients was 40.17 with a standard deviation of ± 16.02. The prevalence of unsuccessful tuberculosis treatment outcomes was 14.29%. Treatment interruption, death, and treatment failure among tuberculosis patients were 1.35%, 7.10%, and 5.83%, respectively. Comorbid diseases were a significant risk factor for unsuccessful tuberculosis treatment outcome (adjusted relative risk (RR) = 3.198, 95% CI 1.755-4.901), P < 0.001). Additionally, age (RR = 1.057, 95% CI 1.036-1.078, p < 0.001), being male (RR = 2.026, 95% CI 1.361-3.016, p = 0.001), living in rural areas (RR = 3.092, 95% CI 2.038-4.691, p < 0.001), and Charlson comorbidity index scores (1, 2, and ≥ 3) were independent predictors of unsuccessful tuberculosis treatment outcome. This study revealed that the prevalence of unsuccessful tuberculosis treatment outcomes was high. Comorbid diseases, Charlson comorbidity index scores (1, 2, and ≥ 3), age, being male, and living in rural areas were predictors for unsuccessful tuberculosis treatment outcome. It is important to implement an integrated management strategy for both tuberculosis and comorbid diseases to reduce the rate of unsuccessful tuberculosis treatment outcomes.

PMID:41865168 | DOI:10.1038/s41598-026-44604-3

Arch Gynecol Obstet. 2026 Mar 21;313(1):139. doi: 10.1007/s00404-026-08359-6.

ABSTRACT

KEY MESSAGE: Compared with conventional locked double-layer closure, an unlocked double-layer, endometrium-sparing closure was associated with lower isthmocele prevalence, greater residual myometrial thickness, and fewer postcesarean symptoms. If these findings are confirmed in prospective studies, adopting this closure approach could help to reduce morbidity related to the niche in routine cesarean practice.

BACKGROUND: Isthmocele, a cesarean scar defect associated with abnormal bleeding, pelvic pain, and diminished fertility, is becoming more well known as a result of the increasing prevalence of cesarean sections. Although the optimal closure technique is still a topic of debate, it is regarded as the most modifiable factor in the prevention of isthmocele.

OBJECTIVE: To compare the effects of the traditional locked double-layer uterine closure technique with the new unlocked double-layer, endometrium-protective technique on isthmocele incidence, residual myometrial thickness (RMT), and post-CS symptoms.

METHODS: From March 2023 to January 2025, a total of 180 women (97 conventional and 83 novel) who underwent low-segment cesarean sections at a tertiary care center were included in a retrospective comparative cohort study. At 12-24 weeks postpartum, residual myometrial thickness (RMT) and isthmocele presence were evaluated using saline-infusion sonohysterography. Independent predictors of RMT and isthmocele were identified through binary logistic and multiple linear regression analyses.

RESULTS: The new method was linked to less need for additional hemostatic sutures (2.4% vs. 11.3%; OR = 5.18), as well as a shorter operating time (26 vs. 33 min, p = 0.001). Compared with the new lockless double-layer technique, traditional locked double-layer closure was associated with a significantly higher risk of isthmocele (39.2% vs. 7.2%; OR = 8.27, 95%CI 3.28-20.85; p = 0.001). Additionally, the mean RMT was greater (13.91 vs. 10.18 mm, p = 0.001). While linear regression connected the novel technique and higher parity to greater RMT and preoperative anemia to decreased healing, logistic regression found that suture technique was the only independent predictor of isthmocele. The novel group had significantly lower rates of postmenstrual spotting, dysmenorrhea, and chronic pelvic pain (p = 0.001 for all).

CONCLUSIONS: Compared to the traditional locking technique, the locking, double-layer, endometrium-sparing uterine closure method, in which the first layer of the uterine incision is continuously sutured without locking and the second layer is reinforced with a continuous ‘U’-shaped suture, results in a statistically significant reduction in isthmocele formation, increased residual myometrial thickness, shorter operative time, and fewer niche-related symptoms. This method appears to improve short-term uterine healing and niche-related symptoms; however, its impact on future reproductive and obstetric outcomes remains unknown and requires prospective validation. However, multicenter studies with extended follow-up periods are warranted to confirm these findings.

PMID:41865166 | DOI:10.1007/s00404-026-08359-6

Ann Biomed Eng. 2026 Mar 21. doi: 10.1007/s10439-026-04089-7. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated tibiofemoral loading and medial meniscal stress distribution in individuals with flexible flatfoot (FFF) during walking under different foot progression angle (FPA) conditions.

METHODS: This study analyzed the gait of 28 FFF patients (16 males, 12 females) under three FPA conditions (neutral, toe-in, toe-out). Kinematic (Vicon) and kinetic (Kistler) data were used to estimate tibiofemoral forces in OpenSim. Subsequently, joint angles and muscle forces at peak tibiofemoral forces were used to drive a finite element (FE) model of the knee, enabling the comparison of meniscal von Mises stress, maximum shear stress, and contact pressure across FPA conditions.

RESULTS: Tibiofemoral force increased during early stance (9-11%) in the toe-in condition with this increase reaching statistical significance in males (p = 0.008, mean partial ${\eta }^2=0.70$ within the SPM-identified cluster). FE analysis showed that peak stresses and contact pressure were primarily localized in the anterior region of the medial meniscus. A consistent directional response to FPA was observed with the lowest peak values occurring in the toe-in condition and the highest values in the toe-out condition.

CONCLUSION: Adjusting FPA modulates intra-articular knee loading via the kinetic chain. For FFF patients, neutral FPA provides stable loading. The toe-in condition presents a complex mechanism: despite increasing tibiofemoral force (notably in males), it reduces peak stress by altering contact mechanics and stress distribution. Therefore, FFF gait interventions must be individualized based on factors like foot morphology, sex, and functional goals.

PMID:41865148 | DOI:10.1007/s10439-026-04089-7

Patient. 2026 Mar 21. doi: 10.1007/s40271-026-00806-5. Online ahead of print.

ABSTRACT

BACKGROUND: Cystic fibrosis (CF) is a progressive and multi-organ genetic condition most renowned for reduced lung function. The recent introduction of elexacaftor/tezacaftor/ivacaftor (ETI) has transformed physical health and life expectancy for many people with CF.

OBJECTIVES: This mixed methods study aimed to compare levels of physical health and self-concept before and after ETI commencement and explore lived experiences of ETI impact on self-concept: an individual’s overarching sense of identity.

METHODS: This study applied a mixed methods approach, using qualitative data to enrich and augment the insights gained by the quantitative data. Longitudinal quantitative data were collected from 20 adults to compare mean lung function, frequency of pulmonary exacerbations, body mass index (BMI), and self-concept scores before and after ETI commencement. Qualitative data were collected from 13 of these adults through in-depth, unstructured interviews, which were thematically analysed to identify key insights.

RESULTS: Descriptive and comparison statistical analysis demonstrated a significant increase in mean lung function and a significant decrease in mean frequency of pulmonary exacerbations following ETI commencement. No significant difference in BMI was identified. While mean self-concept scores before and after ETI commencement were not significantly different, thematic analysis of interview data highlighted that many participants had experienced self-concept recalibration across physical, social, and psychological domains of life related to ETI. The overarching theme of Self-concept recalibration and six subsequent themes emerged: Physical self: A ‘new’ CF and Weight gain – friend or foe; Social self: The gift of time and Goals and possibilities; and Psychological self: from Surviving to thriving and Into the unknown.

CONCLUSIONS: Findings highlight significant physical health improvement for many people with CF, and the potential for ETI to positively impact self-concept. However, challenges and nuanced self-concept experiences were also identified.

PRACTICE IMPLICATIONS: Integration of a self-concept approach to CF care is recommended.

PMID:41865142 | DOI:10.1007/s40271-026-00806-5

Sci Rep. 2026 Mar 22. doi: 10.1038/s41598-026-45385-5. Online ahead of print.

NO ABSTRACT

PMID:41865131 | DOI:10.1038/s41598-026-45385-5