Nevin Manimala

Environ Monit Assess. 2025 Dec 2;198(1):2. doi: 10.1007/s10661-025-14858-x.

ABSTRACT

This study provides a comprehensive long-term assessment of air quality in Balıkesir, northwestern Türkiye, focusing on the spatiotemporal variability of PM₁₀ and SO₂ during 2013-2023. The analysis integrates pollutant observations with ERA5 reanalysis meteorological data to examine seasonal and diurnal variations, long-term trends, and the role of temperature inversions and atmospheric circulation in shaping pollution episodes. Results indicate that both pollutants reach their highest concentrations in winter due to intensified domestic heating and stagnant meteorological conditions, with temperature inversions acting as a key driver of near-surface accumulation. The Theil-Sen trend analysis revealed an insignificant long-term change in PM₁₀ but a statistically significant upward trend in SO₂ (+ 0.5 µg m⁻³ year⁻¹), suggesting persistent reliance on sulfur-rich fuels during the cold season. However, a short-term decline after 2020 reflected the combined effects of cleaner fuels and pandemic-related emission reductions. Correlation analysis demonstrated that PM₁₀ and SO₂ are moderately interrelated (r = 0.49) and primarily controlled by high-pressure, low-wind conditions. HYSPLIT trajectory analyses confirmed that severe winter episodes result from the combined influence of local stagnation and regional air mass transport. These findings highlight the dual importance of emission control and meteorological monitoring in managing winter pollution. Policy recommendations include stricter regulation of heating fuels, inversion-based early-warning systems, and enhanced regional cooperation to mitigate transported particulate matter.

PMID:41329396 | DOI:10.1007/s10661-025-14858-x

Environ Monit Assess. 2025 Dec 2;198(1):1. doi: 10.1007/s10661-025-14760-6.

ABSTRACT

It was presented a reliable statistical assessment of regional background element concentrations with a geochemical framework using the concentrations of Cr, Fe, Ni, Cu, Zn, As, Mo, Pb, and Hg in soils and Hg in air (atmospheric and soil) on the example of the area with ore mineralization and superimposed historical anthropogenic mining activity (Sarala gold-ore group; the Republic of Khakassia, Russia). The most reproducible results were obtained by the 2sd (mean ± 2σ) and 2MAD (median ± 2MAD) statistical methods. The TIF (Tukey inner fence) gave the widest background range. The 2sd method can be used as well as 2MAD, but with careful statistical pre-processing of data. It was found that the upper threshold values of background concentrations of Cr, Fe, Ni, Cu, Zn, As, Mo, Pb, and Hg in soils of the Sarala gold-ore area exceeded the concentrations in the upper continental crust, soils of 4 neighboring objects of the Siberian region, and maximum permissible concentrations. Hg concentrations in air (atmospheric and soil) were higher than in the Northern and Southern Hemispheres and did not exceed the maximum permissible concentration for residential areas. The patterns are typical for areas where ore mineralization zones are located. Based on the comparison of geological and geochemical data with the results of ANOVA (one-way analysis of variance) tests and correlation analysis, the sources of elements were recognized in the study area (geogenic, technogenic, and mixed). The investigation with this kind of statistical approach was realized for the first time in Russia for such a natural-technogenic object, providing research novelty. The results provide reference data for comparing background concentrations in soils in similar mining areas worldwide and can help with making decisions about environmental strategies for specialized measures to ensure public safety.

PMID:41329378 | DOI:10.1007/s10661-025-14760-6

Eur J Orthop Surg Traumatol. 2025 Dec 2;36(1):34. doi: 10.1007/s00590-025-04613-w.

ABSTRACT

PURPOSE: This study aimed to identify patient and injury characteristics associated with reoperation after patella open reduction internal fixation (ORIF).

METHODS: A retrospective review was conducted of patients who underwent operative fixation of patella fractures (AO/OTA 34) from 2012 to 2022 at a single Level I trauma center. Demographic, injury, and operative variables were collected. Primary outcomes were all-cause reoperation, symptomatic implant removal (SIR), fixation failure, and fracture-related infection (FRI). Univariable and multivariable analyses were performed to identify factors associated with reoperation.

RESULTS: Of 497 identified patients, 251 met inclusion criteria. The mean age was 45.8 years, and 57.4% were male. Fifty-six patients (22.3%) required reoperation, most commonly for fixation failure (14.7%). Osteoporosis (33.9% vs 8.2%, p < 0.001), diabetes (23.2% vs 8.2%, p = 0.002), and tobacco use (53.6% vs 30.3%, p = 0.001) were more common among reoperation cases. On multivariable analysis, male sex (OR 2.73, 95% CI 1.07-6.91, p = 0.035), diabetes (OR 4.23, 95% CI 1.37-13.08, p = 0.012), and osteoporosis (OR 8.51, 95% CI 3.03-23.91, p < 0.001) were independently associated with fixation failure, whereas increasing BMI was associated with lower odds of fixation failure (OR 0.93, 95% CI 0.86-1.00, p = 0.049).

CONCLUSION: Reoperation occurred in approximately one in five patients following patella ORIF. Osteoporosis, diabetes, and tobacco use were associated with higher complication rates, while higher BMI was associated with reduced odds of fixation failure. Individualized surgical planning, bone health optimization, and closer follow-up may address complication risk in high-risk patients following patella fracture fixation.

PMID:41329368 | DOI:10.1007/s00590-025-04613-w

Odontology. 2025 Dec 2. doi: 10.1007/s10266-025-01278-z. Online ahead of print.

ABSTRACT

The aim was to evaluate periodontal health in ulcerative colitis (UC) patients and the relationship between UC and periodontitis. Since both diseases are immuno-inflammatory mediated, periodontal parameters and their correlation to disease activity indices in UC patients in comparison with healthy subjects were analysed. A cross-sectional comparative case-control study was conducted involving 80 subjects, consisting of 40 patients with UC and 40 age- and gender-matched healthy controls, all examined at a single time point. Full periodontal examination comprised Plaque Index (PlI), Gingival Index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP). Clinical features of the disease (Mayo score and duration of UC) were documented. Statistical methods employed were independent t-tests, chi-square, and logistic regression model. UC patients had worse periodontal parameters when compared to controls (PlI, GI, PPD, CAL, and BOP; all p < 0.001). Generalized periodontitis was more common in patients with UC (72.5%) than in controls (37.5%; p = 0.002). A slight positive correlation was found between the Mayo score and CAL and BOP. The burden of periodontal disease was significantly higher in UC patients. Incorporating periodontal evaluation and treatment for the management of UC could potentially decrease systemic inflammation and promote overall better health.

PMID:41329362 | DOI:10.1007/s10266-025-01278-z

J Orthop Surg Res. 2025 Dec 2. doi: 10.1186/s13018-025-06547-9. Online ahead of print.

ABSTRACT

BACKGROUND: Humeral lateral condyle fractures are common pediatric elbow injuries, with Jakob type III representing the most severe form. While open reduction and internal fixation is the standard treatment, consensus is lacking on the optimal fixation method. Inadequate fixation can lead to serious complications. The efficacy of absorbable internal fixation materials remains debated. This study aimed to evaluate the outcomes of different internal fixation materials for treating these fractures in children.

METHODS: A retrospective review was conducted on 51 children (39 male, 12 female; mean age 4.8 years) with Jakob type III fractures treated surgically between January 2020 and December 2023. Patients were divided into three groups based on fixation: Kirschner wires (Group A), metal hollow screws (Group B), and absorbable hollow screws (Group C). Statistical significance was set at P < 0.05.

RESULTS: The average hospitalization was 3.8 ± 0.2 days, median operation time was 60 min, and mean follow-up was 25.2 ± 12.1 months. No significant differences were found among groups regarding gender, age, postoperative plaster fixation time, final carrying angle, elbow varus deformity, lateral condyle protrusion, Mayo elbow score, or satisfaction. However, significant differences existed in hospital stay, operation time, time to implant removal, total hospitalization costs, and material costs. Group B had a significantly longer hospital stay (mean 4.9 days) compared to Groups A and C (3.5 and 3.4 days). Operative time was longest in Group A (mean 60 min vs. 45 and 47 min). Implant removal time was significantly longer in Group B (median 93 days vs. 34 days in Group A). Group B had the highest total hospitalization costs (mean $2623.0), while Group C had the highest material costs (mean $996.5). Group A had the lowest costs in both categories.

CONCLUSION: Different internal fixation materials achieved comparable therapeutic effects for pediatric Jakob type III lateral condylar fractures. Absorbable screws provided the advantage of eliminating the need for a second surgery for removal.

PMID:41327221 | DOI:10.1186/s13018-025-06547-9

Malar J. 2025 Dec 1. doi: 10.1186/s12936-025-05699-7. Online ahead of print.

ABSTRACT

BACKGROUND: Recent epidemiological data indicate that 30-50% of all malaria infections are asymptomatic, with parasite densities below the limit of detection of standard diagnostic tests. A highly sensitive rapid diagnostic test (hsRDT) was developed to detect these low-density Plasmodium falciparum infections. This study evaluated the diagnostic performance of both hsRDTs and conventional RDTs (cRDT) in reactive case detection (RACD) activities among individuals (contacts) living and/or working in proximity to an “index case” in Ann Township in Rakhine State, Myanmar.

METHODS: This prospective community-based RACD study was conducted in 2017-2018 among residents aged at least five years old in 50 villages of Ann Township. We assessed the sensitivity, specificity, and positive and negative predictive values of both a hsRDT (NxTek™ Eliminate Malaria Ag P.f) and a cRDT (SD Malaria Ag P.f/P.v) using an ultra-sensitive polymerase chain reaction (usPCR) diagnostic assay as the gold standard.

RESULTS: A total of 1,990 participants, all contacts of 51 index P. falciparum cases, were recruited. Among them, 28 (1.4%) tested positive by cRDT, 78 (3.9%) by hsRDT, and 171 (8.6%) by usPCR for P. falciparum mono-infection. The sensitivity and specificity of the hsRDT were 27.9% (95% CI 18.2-39.6%) and 98.8% (95% CI 98.2-99.4%), respectively, while the sensitivity and specificity of the cRDT were 13.7% (95% CI 7.6-20.7%) and 100% (95% CI 100-100%), respectively. The differences in sensitivity and specificity between hsRDT and cRDT were statistically significant (p < 0.01 for both).

CONCLUSIONS: Although hsRDTs identified more infected contacts than cRDTs during reactive case detection, they have low overall sensitivity compared to usPCR. In resource-limited settings, such as Myanmar, the use of hsRDTs in RACD should be guided by careful consideration of their field feasibility and cost-effectiveness to support malaria elimination efforts. (285 words).

PMID:41327219 | DOI:10.1186/s12936-025-05699-7

BMC Public Health. 2025 Dec 1. doi: 10.1186/s12889-025-25783-6. Online ahead of print.

NO ABSTRACT

PMID:41327211 | DOI:10.1186/s12889-025-25783-6

BMC Pulm Med. 2025 Dec 1;25(1):550. doi: 10.1186/s12890-025-04030-z.

ABSTRACT

BACKGROUND: Computed tomography (CT)-based quantification of coronavirus disease 2019 (COVID-19) pneumonia is widely performed, and total pneumonia volume, ground-glass opacity (GGO), and consolidation affect disease severity. However, there is insufficient information on how consolidation to GGO (C/G) ratio correlates with clinical characteristics including disease severity and complications in COVID-19 patients.

METHODS: This retrospective cohort study included 1,194 hospitalized patients with COVID-19 from four member hospitals of the Japan COVID-19 Task Force. Critical outcomes were defined as conditions requiring high-flow oxygen or invasive mechanical ventilation, or death. Patients were divided into two groups based on %pneumonia (percentage of pneumonia volume divided by total lung volume) using receiver operating characteristic curve, and those with high %pneumonia were further divided into two groups based on C/G ratio. Critical outcomes and complications were then compared between high and low C/G ratio groups.

RESULTS: The optimal cutoff value of %pneumonia to predict critical outcomes was 17.1%, classifying the included patients into low (Group 1, n = 900) and high (n = 294) %pneumonia groups. The optimal cutoff value of C/G ratio was 0.202, classifying patients in the high %pneumonia group into two groups: low (Group 2, n = 192) and high C/G (Group 3, n = 102) ratio groups. The incidence of critical outcomes was stair-step high in all three groups (2.1%, 21.4%, and 37.3%, respectively). Multivariable analysis revealed an independent relationship between C/G ratio and critical outcomes from other known risk factors (adjusted odds ratio: 1.92, 95% confidential interval: 1.03-3.59, P = 0.040). Group 3 also showed significantly higher serum C-reactive protein (Group 1: 2.96 mg/dL, Group 2: 8.90 mg/dL, Group 3: 11.4 mg/dL) and procalcitonin (Group 1: 0.16 ng/mL, Group 2: 0.25 ng/mL, Group 3: 1.19 ng/mL) levels and incidence of bacterial infection (Group 1: 5.6%, Group 2: 10.4%, Group 3: 20.3%), compared with other groups.

CONCLUSIONS: CT-density analysis of COVID-19 pneumonia in a large patient population showed that C/G ratio was a significant predictor of critical outcomes and useful for prognosis evaluation.

PMID:41327196 | DOI:10.1186/s12890-025-04030-z

BMC Med Educ. 2025 Dec 1;25(1):1666. doi: 10.1186/s12909-025-08167-7.

ABSTRACT

BACKGROUND: The COVID-19 pandemic significantly impacted all aspects of human life, including education. Medical universities faced various challenges, including the need for virtual education and changes in educational systems, and were forced to adapt their teaching methods. The goal of this study is to explore the lessons learned from the COVID-19 pandemic in educating medical students and to design a virtual education framework at Tehran University of Medical Sciences.

METHODS: This is a sequential exploratory mixed-method study, consisting of qualitative and quantitative phases. In the qualitative phase, in-depth semi-structured interviews were conducted with 25 faculty members from Tehran University of Medical Sciences. In the so-called “quantitative” phase, a literature review and expert panel were employed; these methods are not inherently quantitative (i.e., they do not involve statistical analysis of numerical data). It is recommended to replace the term “quantitative” with a more accurate descriptor, such as “literature synthesis and expert consensus,” or describe this phase differently. The findings from both phases were subsequently used to design the virtual education framework.

RESULTS: The study revealed that using modern technologies for virtual education in medical universities is crucial and requires strengthening infrastructure. Furthermore, clinical education in a virtual format presents significant challenges and the need for developing blended learning methods. Ultimately, the virtual education framework at Tehran University of Medical Sciences was designed and developed. The virtual education system formulated here focuses on three pillars: infrastructure development, faculty empowerment, and establishing blended learning practices. A short description of the pillars here provides readers with a clearer sense of the framework’s structure and priorities.

CONCLUSION: The COVID-19 pandemic provided an opportunity to assess and improve virtual education at medical universities. Given the successes achieved, it is essential to develop the infrastructure for virtual education and establish clear standards for it so that blended and electronic education can be implemented more effectively alongside in-person education in the future. To address the challenges in clinical education highlighted by the study, implementing blended learning approaches emerges as a key strategy for improving virtual and in-person medical education.

PMID:41327193 | DOI:10.1186/s12909-025-08167-7

BMC Psychiatry. 2025 Dec 1. doi: 10.1186/s12888-025-07675-6. Online ahead of print.

ABSTRACT

BACKGROUND: Attention deficit hyperactivity disorder is a neurodevelopmental disorder marked by a persistent pattern of symptoms, including inattention, hyperactivity, and impulsivity. Children and adolescents with attention deficit hyperactivity disorder may struggle with low self-esteem, troubled relationships, and poor performance in school. Adolescents with attention deficit hyperactivity disorder further have a higher risk of anxiety and depression and increasing risky behaviors, such as substance use. Attention deficit hyperactivity disorder is one of the most common neurodevelopmental disorders in children, affecting approximately 5-8%, primarily boys, and often persisting into adulthood.

OBJECTIVE: The study aimed to assess the prevalence of attention deficit hyperactivity disorder and associated factors among children and adolescents in Borama town, Somaliland, in 2024.

METHODS: A community-based cross-sectional study design was employed involving 422 children and adolescents. The data was collected through face-to-face interviews using a structured questionnaire between April and June 2024. A multistage sampling approach was applied to recruit the study participants. The data was entered into Epi Data 4.6, then exported to SPSS 26.0 for analysis. Binary logistic regression analysis was performed to identify predictors, with statistical significance declared at p-value < 0.05. The presence of attention deficit hyperactivity disorder in children and adolescents was evaluated using the Vanderbilt Attention Deficit Hyperactivity Disorder Diagnostic Parent Rating Scale.

RESULT: The prevalence of attention deficit hyperactivity disorder among children and adolescents in Borama town, Somaliland, was found to be 13.7%. The findings indicated that younger children, aged 6 to 11 years [AOR = 2.2, 95% CI (1.2; 4.15)], single-parent family structures [AOR = 2.4, 95% CI (1.3; 4.6)], maternal health status during pregnancy [AOR = 3.3, 95% CI (1.4; 8.19)], and a family history of mental illness [AOR = 4.1, 95% CI (1.7; 9.6)] were significantly associated with attention deficit hyperactivity disorder.

CONCLUSION: The study revealed a relatively high prevalence of attention deficit hyperactivity disorder among children and adolescents in Borama town. Being young (aged 6 to 11 years), single-parent family structure, maternal health problems during pregnancy, and familial history of mental illness were identified as significant risk factors. Strengthening community support systems, improving maternal healthcare services, and providing mental health support may help reduce the risk factors associated with ADHD in the society.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41327178 | DOI:10.1186/s12888-025-07675-6