Category: Nevin Manimala

BMC Public Health. 2025 Dec 29. doi: 10.1186/s12889-025-26062-0. Online ahead of print.

ABSTRACT

BACKGROUND: Air pollution seriously threatens residents’ respiratory health, the objective of this study is to explore the relationship between air pollution-related factors and chronic respiratory diseases (CRDs), analyze the association between air pollution-related factors and chronic obstructive pulmonary disease (COPD) prevalence, and evaluate the current status of residents’ awareness of air pollution through questionnaire analysis.

METHODS: A cross-sectional was conducted in Minhang District, Shanghai. Personal information, air pollution-related risk factors, and residents’ cognitive level were collected through questionnaire investigations. Descriptive statistics, chi-square tests, univariate and multivariate logistic regression and receiver operating characteristic curve (ROC) were used.

RESULTS: The questionnaire was completed by 3136 respondents. The prevalence of CRDs was 24.6% and COPD was 12.1%. Among the air pollution-related variables, exposure to dust or fumes at work, used to cook with firewood or coal, frequent home cooking, and living proximity to industrial areas or other pollution sources were significantly associated with CRDs. The area under the curves (AUC) of COPD was 0.821 for assessing the prevalence of COPD with basic variables combined with air pollution-related variables. In terms of air pollution cognition, CRDs patients were generally lower than no-CRDs.

CONCLUSION: Air pollution-related factors are significantly related to the prevalence of CRDs, considering the significant harm of air pollution to COPD, it is recommended to add air pollution-related factors to the screening questionnaire of COPD to improve the screening accuracy. In addition, residents’ cognition levels of air pollution are associated with CRDs prevalence.

PMID:41457211 | DOI:10.1186/s12889-025-26062-0

BMC Public Health. 2025 Dec 29. doi: 10.1186/s12889-025-26007-7. Online ahead of print.

ABSTRACT

BACKGROUND: Only little is known about the social and health conditions of overindebted individuals in Switzerland. Very few studies on the mental health outcomes or correlates of overindebtedness have been performed so far, and to date, hardly any study has been conducted on the social well-being and connectedness of overindebted people.

METHODS: Survey data collected in 2019 from clients of all four official debt advisory centers in the Canton of Zurich were used and merged with a subsample of the Swiss Health Survey 2017 of the same age and canton of residence. The combined dataset and pooled study sample covered a total of 2,216 individuals, 219 overindebted adults and 1,997 respondents of the Swiss Health Survey and residents of the Canton of Zurich. Contingency tables were constructed, and multiple logistic and linear regression analyses were performed to estimate different measures of effect or association (bivariate frequency distributions, multiple-adjusted odds ratios, standardized beta coefficients).

RESULTS: Overindebted individuals show a markedly increased frequency and risk of being socially disconnected or isolated. They are much more likely to be insufficiently supported (55%) and to frequently feel lonely (43%) than not overindebted representatives of the general population (10%/4%). Overindebted individuals accordingly have – even after adjustment for control variables – a strongly increased risk of being comparably unsupported (aOR = 12.6) and frequently feeling lonely (aOR = 15.4) in comparison with their counterparts. However, this association does not fully explain the strong negative mental health impact of overindebtedness. Half or less of this effect was indirect and thus was mediated by perceived social support and felt loneliness.

CONCLUSIONS: The very poor mental health status of overindebted people cannot be completely attributed to the strong association between overindebtedness and social disconnectedness that was found in this study and shown for the first time.

PMID:41457206 | DOI:10.1186/s12889-025-26007-7

J Med Virol. 2026 Jan;98(1):e70776. doi: 10.1002/jmv.70776.

ABSTRACT

The burden of hand, foot, and mouth disease (HFMD) in children under five is substantial, with the greatest burden in China. Most cases are mild, although some are severe and even fatal. A vaccine against EV-A71, the pathogen most commonly associated with severe HFMD, was licensed in China in Dec 2015 but not introduced into the National Immunisation Programme (NIP). It was hence not covered by routine national vaccine surveillance and its coverage remained unknown for the years following its initial licensure. Here we report the results of a novel data collection and analysis approach to address this knowledge gap. Local public health entities were invited to report county-specific numbers of EV-A71 vaccine doses administered between 2016 and 2019 in mainland China. A cohort model was then used to estimate vaccine coverage. The association between county-level factors (epidemiological, socioeconomic, demographic, and environmental) and vaccine coverage was assessed using zero-inflated beta regression models. We received responses from 2,248 out of 3,252 counties in 23 of 31provinces in mainland China. The median county-level EV-A71 vaccine coverage was 10.17% [IQR: 3.50%, 19.39%] in 2018 and 16.70% [IQR: 8.78%, 27.45%] in 2019. However, the median absolute differences in coverage (i.e., max-min) within-prefecture were ~30%. Results from the regression model indicate that low vaccine coverage was associated with low socioeconomic status, small populations and high proportions of young children. Coverage of EV-A71 vaccines was low in China prior to the COVID-19 pandemic, with substantial geographical disparities over 4 years after the initial vaccine licensure. Our results illustrate the private market response to a new childhood vaccine that is licensed but not centrally funded. Despite economic growth, vaccine coverage among marginalised populations will likely be low without targeted policy and financial support.

PMID:41457185 | DOI:10.1002/jmv.70776

Cardiovasc Intervent Radiol. 2025 Dec 28. doi: 10.1007/s00270-025-04303-4. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the feasibility, safety, and short-term outcomes of off-label stent use for extracranial internal carotid artery (ICA) revascularization in anatomically challenging patients.

METHODS: We conducted a retrospective multicenter cohort study including all consecutive patients treated for extracranial internal carotid artery stenosis between 2017 and 2025 across several high-volume stroke centers. Patients underwent one of three revascularization strategies: carotid endarterectomy (CEA), conventional carotid artery stenting (CAS), or off-label intracranial stent deployment in patients where severe tortuosity, high-cervical anatomy, sharply angulated bulbs, or unfavorable access rendered CEA and standard CAS technically unfeasible. Clinical presentation, angiographic severity, technical success, 30 day mortality, restenosis ≥ 50% at 3 months, and functional outcome (modified Rankin Scale (mRS) ≤ 2) were recorded. Three-group comparisons were performed using ANOVA/Kruskal-Wallis and chi-square/Fisher’s exact tests. Given the small, anatomically preselected off-label cohort and low event numbers, neither propensity score matching nor multivariable regression was feasible. Statistical significance was set at p < 0.05.

RESULTS: A total of 1,522 patients underwent carotid revascularization (48 ACCLINO® stent, 1,274 CAS, 200 CEA). At baseline, pre-procedural near-occlusion or complete occlusion was significantly more common in the off-label group (68.8% [33/48]) compared with CAS (25.5% [325/1274]) and CEA (23.0% [46/200]) (p < 0.001). Symptomatic presentation was also highest in the off-label cohort (100% [48/48]) versus CAS (75.6% [963/1274]) and CEA (81.5% [163/200]) (p < 0.001). Acute ischemic stroke occurred in 25.0% (12/48), 7.8% (99/1274), and 6.0% (12/200) respectively (p < 0.001). Technical success was achieved in all off-label and CEA procedures and in 99.4% of CAS (p = 0.41). Thirty-day mortality did not differ significantly (6.3% vs. 2.7% vs. 3.0%; p = 0.17). At 3 months, restenosis ≥ 50% was comparable across groups (4.2% vs. 5.3% vs. 5.5%; p = 0.78). Functional independence (mRS ≤ 2) improved from 31.3 to 100% in the off-label cohort (p < 0.001), compared with 87.2% → 96.5% in CAS and 82.0% → 94.0% in CEA (all p < 0.001).

CONCLUSIONS: Off-label stenting may offer high technical feasibility, acceptable vessel patency, and meaningful functional recovery in patients with complex, surgically challenging proksimal ICA stenosis, suggesting that it could serve as a potential rescue option in carefully selected anatomically difficult patients.

PMID:41457160 | DOI:10.1007/s00270-025-04303-4

Cardiovasc Intervent Radiol. 2025 Dec 28. doi: 10.1007/s00270-025-04310-5. Online ahead of print.

ABSTRACT

PURPOSE: To develop expert consensus recommendations for patient selection and procedural techniques in cryoneurolysis for chronic pain management using a Delphi process.

MATERIALS AND METHODS: A panel of 22 international interventionists participated in a two-round Delphi process. Participants rated 42 statements on a 10-point Likert scale (1 = strongly disagree, 10 = strongly agree). Consensus was predefined as ≥ 75% of ratings ≥ 7. Descriptive statistics (n, mean ± SD, % ≥ 7) were calculated.

RESULTS: High agreement supported cryoneurolysis for localized chronic pain refractory to conservative therapies (mean 8.55 ± 0.60; 100% ≥ 7) and cases with identifiable peripheral nerve targets (8.45 ± 0.74; 100% ≥ 7). Imaging guidance was deemed essential for nerve identification and probe placement (8.91 ± 0.29; 100% ≥ 7). The panel endorsed individualized freeze-thaw cycles to achieve Sunderland II injury (8.27 ± 0.83; 91% ≥ 7) and emphasized thorough patient education (9.0 ± 0.0; 100% ≥ 7). Experts recommended repeat cryoneurolysis within weeks if initial response was incomplete (8.64 ± 0.65; 100% ≥ 7) and alternative therapies after two unsuccessful sessions (8.36 ± 0.73; 95% ≥ 7). No consensus was reached on restricting treatment to a single anatomical region (5.82 ± 2.91; 50% ≥ 7) or routine prophylactic antibiotics (6.27 ± 2.57; 54% ≥ 7).

CONCLUSION: This Delphi study establishes expert-derived consensus standards for cryoneurolysis, highlighting careful patient selection, mandatory imaging guidance, and flexible freeze protocols while identifying areas requiring further research.

PMID:41457159 | DOI:10.1007/s00270-025-04310-5

Discov Ment Health. 2025 Dec 28. doi: 10.1007/s44192-025-00361-9. Online ahead of print.

ABSTRACT

Amongst the correctional worker population, a wide range of demographic characteristics shape mental health outcomes, organizational stigma, and treatment-seeking, including gender and/or sex differences. Yet, considerations of the relationship between gender and especially sex and mental health in correctional systems internationally remain understudied and have not been investigated on a national scale. In the current national study, we quantitatively analyze Canadian provincial and territorial correctional workers’ (n = 3,740) sex correlates with other sociodemographic variables, and examine the prevalence of potentially psychologically traumatic events (PPTEs), correctional-specific PPTEs, occupational stressors, suicide-related behaviour (ideation, plan, and attempt), and several mental health disorders. Survey findings indicate statistically significant sex differences in exposure to all types of PPTEs, with the exception of captivity and life-threatening illness or injury. Males reported higher odds of being exposed to all types of PPTEs than females, with the exception of sexual assault and other unwanted or uncomfortable sexual experiences, which females had higher odds of experiencing. Statistically significant sex differences were also evident in exposure to all types of correctional-specific PPTEs, except for instances where a person died while under their supervision. Other significant relationships found are discussed and reiterate the necessity of incorporating concerns for gender and/or sex equality and balance in correctional settings into mental health training regimen, as well as highlight several areas for future research.

PMID:41457148 | DOI:10.1007/s44192-025-00361-9

J Gastrointest Cancer. 2025 Dec 28;56(1):246. doi: 10.1007/s12029-025-01367-w.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) remains the third leading cause of cancer-related deaths in the United States. Although diagnostic and treatment improvements have reduced overall mortality, disparities persist across populations and regions.

METHODS: We analyzed the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999-2023), calculating age-adjusted mortality rates (AAMRs) per 100,000 and average annual percent change (AAPC), stratified by age, sex, race, urbanization, and state.

RESULTS: From 1999 to 2023, the overall AAMR for CRC declined by 38.9 percent, from 32.06 to 19.57 per 100,000 (AAPC: -2.08). However, disparities remain. In 2023, males had an AAMR of 23.23, which was 41.1 percent higher than that of females at 16.45. Non-Hispanic (NH) Black individuals had the highest mortality (AAMR: 24.90). Among adults aged 35 to 44, the AAMR rose from 2.87 to 3.71 (AAPC: 1.03), marking a 29.3 percent increase. Nonmetropolitan areas had a 24.0% higher mortality rate than metropolitan areas, with AAMRs of 23.16 and 18.69, respectively. Southern states such as Texas and Georgia saw notable increases in death counts, rising by 34.1 and 38.7 percent, respectively.

CONCLUSION: Despite overall progress, rising mortality in adults under 55 and certain racial groups signals an urgent need for targeted action. Recommendations include refining racial categories in national data, expanding screening in high-risk states with slower mortality declines, and providing mobile screening units in rural areas with consistently high AAMR. Additionally, recovery efforts should address COVID-19-related backlogs in screening, diagnostic colonoscopy, and timely treatment.

PMID:41457141 | DOI:10.1007/s12029-025-01367-w

Brain Inform. 2025 Dec 28. doi: 10.1186/s40708-025-00284-9. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVE: Predicting neurological outcomes in comatose cardiac arrest survivors remains challenging. Diffusion tensor imaging (DTI) offers potential as an objective biomarker of white matter injury, but its prognostic value needs further validation. We aimed to investigate the predictive value of DTI-derived metrics for six-month neurological outcomes in comatose cardiac arrest patients.

METHODS: This prospective study enrolled 28 comatose cardiac arrest patients (mean age 54.36 ± 3.01 years; 71% male) and 28 age-/sex-matched healthy controls (HCs). All participants underwent 3T brain MRI (median 4 days post-arrest). DTI parameters (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], radial diffusivity [RD]) were analyzed using Tract-based spatial statistics (TBSS) and ROI approaches based on white matter atlas. Neurological outcome was assessed at six months using the modified Rankin Scale (good outcome: mRS 0-2; poor outcome: mRS 3-5). Statistical analyses included voxel-wise comparisons and ROC curve analysis for predictive performance.

RESULTS: Compared to HCs, patients showed widespread reductions in FA, MD, AD, and RD (TFCE-corrected p < 0.05). Patients with poor outcomes (n = 18) exhibited significantly lower DTI metrics than those with good outcomes (n = 10) across most white matter tracts. The combination of whole-brain FA and RD demonstrated exceptional prognostic accuracy for good outcome (AUC = 0.984; 95% CI 0.925-1.000; sensitivity 92%, specificity 97.7%), significantly outperforming clinical variables and individual DTI parameters. ROI analysis identified specific tracts (e.g., right cingulum hippocampus, right uncinate fasciculus) with high predictive values. Ventricular fibrillation as initial rhythm was more frequent in the group with good outcomes.

CONCLUSIONS: DTI metrics, particularly the combination of FA and RD, provided outstanding early prediction of good six-month neurological outcomes after cardiac arrest, surpassing traditional biomarkers. These findings supported integrating DTI into multimodal prognostic models to guide clinical decisions and prevent premature withdrawal of life-sustaining therapy.

PMID:41457125 | DOI:10.1186/s40708-025-00284-9

Neurol Sci. 2025 Dec 29;47(1):60. doi: 10.1007/s10072-025-08688-5.

ABSTRACT

BACKGROUND: Most of the function-focused interventions performed on hemiparetic individuals consist of motor training.

OBJECTIVES: The aim of this study was to examined the effects of sensory training applied to the lower extremity on light touch, proprioception, balance, walking and functional capacity.

METHODS: 42 hemiparetic individuals were included in the study as Control(n = 21) and Study(n = 21) groups. The Bobath approach, as a neurodevelopmental treatment training was implemented across all groups for four weeks, with a frequency of three 45-minute sessions per week. In addition, the study group also received sensory training. Pre-treatment and post-treatment(4weeks) evaluations were performed. Motricity Index, Semmes-Weinstein Monofilament Test for sole sensation, Lower Extremity Position Test, electrogoniometric measurements for kinesthesia, Portable Computerized Balance Device for balance, and Portable Gait Analysis device for walking were used in the evaluations.

RESULTS: In the study group, statistically significant improvement was observed in the motricity index, sole sensation, especially in the forefoot region, 22 cm position sensation, and ankle kinesthesia sensation(p < 0.05). In addition, there was a statistically significant improvement in the hemiparetic side and total balance score in the balance assessment in the study group(p < 0.05). Significant improvement was found in the gait speed, hemiparetic side stride length, healthy side step length, and healthy side stride length parameters, as well as hemiparetic side pelvic propulsion angle in the study group(p < 0.05). In the control group, no statistically significant improvement was achieved in any parameter(p > 0.05).

CONCLUSION: Participants showed improved functionality, sensation, balance, and gait after sensory training. Somatosensory training enhances functional status in hemiparesis rehabilitation.

PMID:41457106 | DOI:10.1007/s10072-025-08688-5

Nat Commun. 2025 Dec 29. doi: 10.1038/s41467-025-68027-2. Online ahead of print.

ABSTRACT

Recent evidence highlights the significance of a new type of tumour suppressors, which are not frequently mutated but inhibited by metabolic cues in cancers. Here, we identify BATF2 as a tumour suppressor whose expression is epigenetically silenced by glutamine in Head and Neck Squamous Cell Carcinomas (HNSCC). BATF2 correlates with type-I interferon and Th1 signatures in human HNSCC, with correlation coefficients even stronger than those of the positive control, STING. The phosphorylation of BATF2 at serine 227 promotes the oligomerization of STING. BATF2 deficiency or high glutamine levels result in higher oxygen consumption rates and metabolic profiles unfavorable for type-I interferon production. An isocaloric glutamine-rich diet abolishes STING-mediated effector cell expansion in tumours, weakening STING agonist-induced tumour control. Cancer cell-specific BATF2 expression promotes an Id2-centered T-cell effector signature, reduces T-cell exhaustion, and triggers spontaneous HNSCC rejection in a type-I interferon-dependent fashion. Utilizing syngeneic subcutaneous, orthotopic, and 24-week-long cigarette smoke carcinogen-induced HNSCC models, we demonstrate that host Batf2 deficiency results in increased infiltration of CD206⁺ myeloid cells and reduced effector CD8⁺ T-cells, accelerating the initiation of cancers. Overall, we reveal a tumour suppressor BATF2 whose loss is mediated by unique metabolic cues in the TME and drives cancer immune escape.

PMID:41457098 | DOI:10.1038/s41467-025-68027-2