Nevin Manimala

Pediatr Pulmonol. 2026 Mar;61(3):e71569. doi: 10.1002/ppul.71569.

ABSTRACT

BACKGROUND: Asthma rates are rising globally, posing a significant public health challenge. In Qatar, childhood asthma affects 34.6% of children, making it a common chronic condition. The global scope of existing literature on the association between childhood asthma and perinatal and neonatal risk factors may not fully account for Qatar’s distinctive socio-cultural, genetic, and healthcare aspects. Therefore, this research aims to emphasize the importance of considering regional variations in health outcomes.

OBJECTIVES: To investigate the association between childhood asthma development and mode of delivery, gestational age, and birthweight in Qatar.

METHODS: A hospital-based case-control study was conducted in Qatar across Hamad General, Al Wakrah, and Al Khor hospitals from January 2020 to July 2023, including 830 asthma cases and 1,512 non-asthma controls aged 6-14 years. Secondary data from Electronic Medical Records were analyzed using logistic regression, with odds ratios (ORs) and adjusted odds ratios (aORs) calculated for each factor. Confounders were managed through Directed Acyclic Graphs (DAG), and multiple imputations addressed missing data.

RESULTS: Asthma prevalence was 35.4%. Compared to controls, asthma cases were more likely to be males (65% vs. 41%) and have a family history of asthma (31.3% vs. 1.7%). In addition, Cesarean delivery (aOR 1.15, 95% CI 0.92, 1.44), preterm birth (aOR 1.07, 95% CI 0.79), and low birth weight (aOR 1.03, 95% CI 0.61, 1.73) showed slight increases in asthma risk. However, none of these associations reached statistical significance.

CONCLUSION: Despite non-significant associations, findings underscore the importance of considering regional variations and context-specific research.

PMID:41865305 | DOI:10.1002/ppul.71569

Int J Soc Psychiatry. 2026 Mar 22:207640261427415. doi: 10.1177/00207640261427415. Online ahead of print.

ABSTRACT

BACKGROUND: Since the 2022 full-scale invasion of Ukraine, civilians have experienced substantial war-related trauma, yet little is known about the prevalence and risk factors of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) among internally displaced persons (IDPs) actively seeking medical or psychological care.

AIMS: To examine the prevalence of PTSD and CPTSD in a clinical sample of Ukrainian IDPs, compare diagnostic rates between psychological and medical treatment-seekers, and identify sociodemographic and war-related predictors of diagnostic outcomes.

METHODS: A total of 224 adult IDPs attending an outpatient clinic in Chernivtsi oblast completed the International Trauma Questionnaire. Descriptive statistics, bivariate analyses, and multinomial logistic regression models were used to assess prevalence and identify predictors of PTSD and CPTSD.

RESULTS: In the full sample, 24.5% met criteria for ICD-11 PTSD and 7.6% for CPTSD. Among psychological treatment-seekers, prevalence was higher (PTSD: 28.3%; CPTSD: 9.0%) compared to those seeking exclusively medical care (PTSD: 13.8%; CPTSD: 3.4%). Losing someone close due to the war significantly predicted both PTSD and CPTSD in the final multivariable model, while male gender independently predicted CPTSD.

CONCLUSIONS: PTSD rates in this sample were broadly comparable to global estimates for conflict-affected populations, whereas CPTSD prevalence appeared lower than that reported in other Ukrainian samples. Relocation to safer areas within one’s own country-without the additional stressors associated with forced international migration-together with the relatively older age of the sample, may have contributed to a reduced CPTSD risk. Sociocultural expectations surrounding masculine roles during wartime might also play a role in male vulnerability to CPTSD, though further evidence is needed. Individuals bereaved by the war may represent a subgroup at heightened risk, highlighting the potential value of targeted psychosocial support. Longitudinal, multi-site studies with diverse samples are needed to clarify symptom trajectories and contextual risk factors in displaced civilians.

PMID:41865301 | DOI:10.1177/00207640261427415

Pediatr Pulmonol. 2026 Mar;61(3):e71580. doi: 10.1002/ppul.71580.

ABSTRACT

BACKGROUND: Pediatric inflammatory bowel disease (IBD) is increasingly recognized as a systemic disorder with potential pulmonary involvement, although abnormalities are often subclinical and underdiagnosed.

OBJECTIVE: To systematically review and meta-analyze pulmonary function in children with IBD.

METHODS: PubMed and Scopus were searched from inception to June 30, 2025 for observational studies reporting pulmonary function tests in patients younger than 18 years with Crohn’s disease (CD) or ulcerative colitis (UC), using relevant keywords. Data were synthesized qualitatively and, where possible, pooled using random-effects meta-analysis. Study quality was appraised using the NIH quality assessment tools for observational and case-control studies.

RESULTS: Eight studies involving 395 children and adolescents (244 with CD, 151 with UC) were included. Spirometry indices were largely preserved: pooled estimated mean difference (MD) for FEV₁% predicted was -2.9 (95% CI: -6.0 to 0.3; p = 0.08) and for FVC% predicted -0.8 (95% CI: -2.1 to 0.5; p = 0.21). FEV₁/FVC ratios showed no significant differences (MD -0.5, 95% CI: -1.6 to 0.5). Lung volumes were comparable (TLC% predicted MD -0.8, 95% CI: -1.9 to 0.3). The most consistent abnormality, although not statistically significant, was reduced diffusing capacity: DLCO% predicted was lower in IBD patients (MD -5.8, 95% CI: -12.4 to 0.9; p = 0.09). FeNO levels were similar (MD 0.2 ppb, 95% CI: -3.4 to 3.8).

CONCLUSIONS: Pediatric IBD is associated with predominantly subclinical pulmonary involvement, with reduced diffusing capacity emerging as the most consistent abnormality despite preserved spirometry. Longitudinal studies are needed to clarify the clinical significance and evolution of these findings.

PMID:41865300 | DOI:10.1002/ppul.71580

Diabetes Metab Res Rev. 2026 Mar;42(3):e70159. doi: 10.1002/dmrr.70159.

ABSTRACT

BACKGROUND: The optimal timing for basal insulin initiation in diabetic ketoacidosis (DKA) remains unclear. British guidelines endorse early basal insulin (EBI), while the American Diabetes Association emphasises overlap duration with intravenous insulin, without mention of timing. This meta-analysis evaluates whether EBI administration of basal insulin improves clinical outcomes in adults with DKA.

METHODS: A systematic review and meta-analysis were performed according to the PRISMA guidelines. Databases searched included MEDLINE, Embase, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials through December 11, 2024. Inclusion criteria included articles in the English-language randomised controlled trials (RCTs) or observational studies evaluating EBI in adult DKA patients. Non-human studies, conference abstracts, and case reports were excluded. The primary outcome for this study was hospital length of stay (LOS). Additional outcomes included intensive care unit (ICU) LOS, time to DKA resolution, hypoglycemia, and rebound hyperglycemia between EBI and usual care. Risk of bias was assessed using the Cochrane and Newcastle-Ottawa tools. Grading of Recommendations Assessment, Development, and Evaluation was performed to evaluate the quality of evidence.

RESULTS: From 1214 identified studies, eight (4 RCTs, 4 observational) met inclusion criteria for a total of 247 patients in the EBI group and 552 patients in the control group. No significant difference in hospital LOS was found (mean difference -11.17 h; 95% CI: -29.91 to 7.56). ICU LOS, time to DKA resolution, incidence of hypoglycemia, and rebound hyperglycemia also did not demonstrate any significant differences between groups. Significant heterogeneity existed across studies for most outcomes. All studies had a high risk of bias, and the quality of evidence was very low.

CONCLUSION: EBI did not result in significant differences in hospital LOS, ICU LOS, or time to DKA resolution; however, there were no increased adverse events with EBI. Current studies of early EBI have significant limitations. Future research should focus on developing high-quality RCTs.

PMID:41865288 | DOI:10.1002/dmrr.70159

J Trop Pediatr. 2026 Feb 9;72(2):fmag007. doi: 10.1093/tropej/fmag007.

ABSTRACT

Human milk is the optimal source of nutrition for preterm infants, significantly reducing neonatal morbidities and enhancing neurodevelopmental outcomes. However, preterm neonates face challenges in direct breastfeeding due to immaturity, maternal-infant separation, and inadequate milk production. The aim of this study is to compare the impact of a structured early intervention package on exclusive breastfeeding rate and compare that to a control group that had no structured early intervention package regarding exclusive breastfeeding at 6 months of chronological age in neonates born at less than 34 weeks. Eligible mother-infant dyads were divided into the control and intervention groups. While both the groups received breastfeeding counseling, the control group received routine counseling as per WHO guidelines during antenatal visits, hospital stay, and follow-up immunization visits. In contrast, the intervention group received structured, frequent counseling using specially developed education materials, including intrapartum counseling in the pre-labor area, early initiation of expression facilitated by designated personnel, and scheduled postnatal sessions. Breast milk output was measured at days 3, 7, and 14 or discharge. Exclusive breastfeeding rates were assessed at 6 months. Among 90 enrolled dyads, the exclusive breastfeeding rate at 6 months was significantly higher in the intervention group (75.0%) compared to the control group (47.3%) (P value = .015). Breast milk output on day 3 was also significantly higher in the intervention group (P value = .008). The findings indicate that integrating structured lactation support into neonatal care can improve breastfeeding outcomes, and larger studies are needed to validate these results.

PMID:41865274 | DOI:10.1093/tropej/fmag007

Eur J Public Health. 2026 Mar 14;36(2):ckag037. doi: 10.1093/eurpub/ckag037.

ABSTRACT

While alcohol’s health effects are well documented, less is known about how health influences alcohol use and whether this varies by socioeconomic position (SEP). This study investigated the association between health-related quality of life (HRQoL), mental health, and alcohol use, and whether SEP moderates these associations. Baseline data from 7097 participants in the 2010 Stockholm Public Health Cohort were used. The exposures were HRQoL and mental health (good, moderate, poor); Outcomes (2014) were heavy episodic drinking (HED: ≥5 units/≥2 times/month) and heavy drinking (men: ≥21 units/week; women: ≥14 units/week). Logistic regression estimated odds ratios (OR), with interaction assessed using relative excess risk of interaction (RERI) and attributable proportion (AP). Joint exposure analyses used good health and high SEP as the reference group. Compared with good HRQoL, moderate (OR: 1.26, 95% CI: 1.02-1.56) and poor HRQoL (OR: 1.39, 95% CI: 1.08-1.78) were associated with higher odds of heavy drinking. Moderate HRQoL and low SEP had increased odds of HED (OR: 1.48, 95% CI: 1.02-2.15) and heavy drinking (OR: 1.62, 95% CI: 1.01-2.60), with evidence of additive interaction (RERI: 0.79; AP: 0.49). Mental health findings were less consistent: good mental health and low SEP was associated with increased HED (OR: 1.35), while moderate mental health and intermediate SEP was associated with decreased HED (OR: 0.66). Findings suggest a dose-response relationship between HRQoL and self-reported heavy drinking and an interaction between moderate HRQoL and low SEP. Associations with mental health were weaker and inconsistent.

PMID:41865263 | DOI:10.1093/eurpub/ckag037

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