Nevin Manimala

J Cachexia Sarcopenia Muscle. 2026 Apr;17(2):e70265. doi: 10.1002/jcsm.70265.

ABSTRACT

BACKGROUND: Grip strength is increasingly recognized as a modifiable and easily measurable protective factor against chronic diseases. Lower grip strength may compromise joint stability, predisposing periarticular tissues to local inflammation, which has been implicated in hand osteoarthritis (HOA), a condition affecting approximately 189 million people globally and imposing substantial health and socio-economic burden. Whether lower grip strength is a risk factor for clinically relevant symptomatic HOA remains unclear. We aimed to examine the association between grip strength and incident symptomatic HOA to inform targeted preventive strategies.

METHODS: We conducted prospective cohort studies and Mendelian randomization analyses using data from the Xiangya Osteoarthritis (XO) Study and UK Biobank. Individuals without baseline symptomatic or hospital-diagnosed HOA were included. Genetic instruments for grip strength were derived from genome-wide association studies. Symptomatic HOA in the XO Study was defined as the presence of radiographic HOA with symptoms, whereas hospital-diagnosed HOA in the UK Biobank was ascertained through hospital inpatient records.

RESULTS: Among 2869 XO Study participants (5461 hands; 55.9% women; mean age of 63.2 years), 166 (3.0%) hands developed incident symptomatic HOA during a mean follow-up of 3.7 years. Compared with the lowest grip strength quartile, odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) of symptomatic HOA in the second, third and highest quartiles were 0.51 (95% CI, 0.31-0.84), 0.62 (95% CI, 0.39-0.99) and 0.46 (95% CI, 0.28-0.75), respectively (p for trend = 0.003). Similar associations were observed among 481 582 UK Biobank individuals (54.2% women; mean age of 56.4 years). Mendelian randomization analyses showed ORs of genetically determined grip strength of 0.56 (95% CI, 0.40-0.78, p < 0.001) for incident symptomatic HOA in the XO Study and 0.37 (95% CI, 0.25-0.56, p < 0.001) for incident hospital-diagnosed HOA in the UK Biobank.

CONCLUSIONS: Higher grip strength was associated with a lower risk of incident symptomatic HOA. These findings offer empirical evidence that interventions aimed at enhancing grip strength may help prevent symptomatic HOA and reduce its individual and societal burden.

PMID:41914213 | DOI:10.1002/jcsm.70265

Nurs Open. 2026 Apr;13(4):e70521. doi: 10.1002/nop2.70521.

ABSTRACT

AIMS: This study aimed to assess differences in perceived stress levels and their influencing factors among nursing interns during different periods of a public health emergency.

DESIGN: A cross-sectional study.

METHODS: The survey was conducted at a tertiary hospital in Jiangsu Province, China, from July to August in 2019, 2020, and 2021. A total of 355 nursing interns participated. Data included general information (gender, age, etc.), scores of the Internship Nurse Stressor Scale, and WHOQOL-BREF (physiological, psychological, social, environmental dimensions). Correlation analysis explored relationships between variables, and multiple linear regression identified influencing factors of stress.

RESULTS: Participants were predominantly female (335/355). Stress levels were moderate across periods but significantly different (F = 4.513, p = 0.012). Influencing factors varied. In 2019, factors influencing stress included being an only child (β = 0.206, p = 0.026) and the physiological dimension score of the WHOQOL-BREF (β = -0.257, p = 0.031) [R² = 0.173, F = 2.850, p = 0.006]. In 2020, the psychological dimension score of the WHOQOL-BREF was the main factor (β = -0.326, p = 0.035) [R² = 0.112, F = 2.563, p = 0.023], whereas in 2021, the physiological dimension score was the primary influencing factor (β = -0.448, p < 0.001) [R² = 0.394, F = 7.093, p < 0.001].

PUBLIC CONTRIBUTION: This study provides valuable evidence on the stress levels and influencing factors of nursing interns across different periods of public health emergencies. Relevant departments within schools and hospitals should monitor interns’ physical well-being, taking into account the workload and challenges associated with their internships whether it is before the outbreak or during the later period of public health emergencies. During the early period, addressing their psychological well-being is particularly important. This can be achieved by establishing effective psychological support channels and offering counselling services.

PMID:41914211 | DOI:10.1002/nop2.70521

Emerg Med Australas. 2026 Apr;38(2):e70249. doi: 10.1111/1742-6723.70249.

ABSTRACT

OBJECTIVE: Abdominal pain is a common emergency department (ED) presentation. Currently, there is limited Australian literature detailing whether biological sex results in differences in analgesia provision for abdominal pain. The primary aim of this study is to determine whether there is a difference in time to analgesia administration based on biological sex for patients presenting with abdominal pain to the ED.

METHODS: This was a retrospective, single centre cohort study of adult patients presenting to the Royal Melbourne Hospital ED between April 1st and 30th 2024 with abdominal pain. Data relating to the patient’s presentation and management were collected from records of eligible patients.

RESULTS: Of 708 eligible patients, 292 (41%) were biologically male and 416 (59%) female. There were 559 (80%) patients who received at least one dose of analgesia. Females waited a median of 75 min and males 59 min to receive their first dose of analgesia (difference in medians = 16 min, 95% confidence interval [CI] 0.9-31.0 min, p = 0.04). Females were also nearly half as likely to receive parenteral analgesia (OR 0.56, 95% CI 0.38-0.82, p = 0.003). We found minimal differences in diagnoses, triage category or pain scores between sexes.

CONCLUSION: Females presenting to the ED with abdominal pain are waiting longer than males to receive their first dose of analgesia and are less likely to receive parenteral analgesia. Further research is required to determine the reason for this discrepancy and to then remediate it.

PMID:41914210 | DOI:10.1111/1742-6723.70249

Diabetes Metab Res Rev. 2026 May;42(4):e70164. doi: 10.1002/dmrr.70164.

ABSTRACT

AIMS: To assess the global burden, trends, and inequalities of diabetes prevalence and treatment coverage among adults aged ≥ 45 years from 1990 to 2040.

MATERIALS AND METHODS: Diabetes prevalence and treatment coverage data were obtained from the NCD-RisC database. Average annual percentage changes (AAPC) were estimated using join point regression, and a Bayesian age-period-cohort model was used to project diabetes prevalence and treatment coverage from 2023 to 2040. Cross-national health inequalities were measured using the slope index of inequality (SII) and the relative concentration index (RCI).

RESULTS: Globally, diabetes prevalence rose from 12.85% in 1990 to 23.57% in 2022 (AAPC = 1.90%), and is projected to reach 37.44% by 2040 (AAPC = 2.59%). Treatment coverage grew from 33.22% to 45.88% (AAPC = 1.02%) and is projected to surge to 51.64% by 2040 (AAPC = 0.65%). Diabetes prevalence grew fastest in middle-income countries, whereas treatment coverage improved most in higher-income countries. The SII for prevalence burden decreased from -0.25% in 1990 to -14.86% in 2022, and is projected to further decline to -18.32% by 2040. For treatment coverage, the SII increased from 24.57% in 1990 to 43.91% in 2022, with a projected rise to 54.22% by 2040. The relative inequality measured by the RCI showed a similar pattern.

CONCLUSION: Between 1990 and 2040, diabetes prevalence is projected to increase significantly, while treatment coverage shows only limited improvement. Over the same period, the diabetes prevalence burden is increasingly concentrated in resource-limited regions, while treatment accessibility is becoming progressively more concentrated in economically developed areas.

PMID:41914208 | DOI:10.1002/dmrr.70164

Int Marit Health. 2026;77(1):50-54. doi: 10.5603/imh.111379.

ABSTRACT

BACKGROUND: Poland, a Central European country with the population of 37.5 million and a steadily improving economic situation, has experienced a continuous increase in the number of international travels, exceeding 15 million annually. The aim of this article was to profile Polish travellers seeking pre-departure advice between 2024 and 2025 at the largest diagnostic and treatment center for tropical and travel medicine in Poland.

MATERIAL AND METHODS: This retrospective study was based on the analysis of medical records of patients seeking pre-travel consultations at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland. The dataset included 2,197 visits recorded in 2024 and 3,073 visits in 2025. The analysis focused on the following variables: age, sex, and travel-related characteristics, including purpose of travel, duration of stay, month of departure, and planned destinations by continent and country. The scope of preventive measures recommended or administered during consultations, including immunoprophylaxis and chemoprophylaxis, was also evaluated. Additionally, the health status of patients presenting to the travel medicine centre was assessed.

RESULTS: Patients seeking pre-travel advice were predominantly aged 18-35 years (49.5%) in 2024 vs. 46-65 years (50.5%) in 2025. Most of the examined patients travelled for tourism purposes, typically for up to 4 weeks, with departures most frequently planned for November, January, and February. The majority of travellers intended to visit Asia and Africa, most commonly Thailand (22.3% in 2024, 21.0% in 2025), Vietnam, Kenya, Indonesia, Tanzania, and India. The most frequently administered immunoprophylaxis included vaccinations against typhoid fever, hepatitis A, tetanus/diphtheria/pertussis/poliomyelitis and rabies. Other commonly recommended preventive measures included insect repellents, sunscreen, antidiarrheal medications, antimalarial drugs, and antithrombotic agents. Analysis of patient interviews showed that 41.4% of travellers admitted at the UCMTM in 2024 had underlying medical conditions. In contrast, among patients presenting for pre-travel consultations in 2025, as many as 62.0% reported various health problems. The most commonly reported medical conditions included allergies, thyroid disorders, cardiovascular diseases, psychiatric disorders, and gastrointestinal diseases.

CONCLUSIONS: A substantial proportion of Polish travellers visit destinations associated with an increased risk of infectious diseases. At the same time, due to the ageing of the Polish population, individuals aged 46-65 travel more frequently, including patients with chronic diseases or disorders. Providing professional medical advice during pre-travel consultations plays a crucial role in reducing the risk of travel-related health problems and improving overall travel safety.

PMID:41914195 | DOI:10.5603/imh.111379

Int Marit Health. 2026;77(1):39-49. doi: 10.5603/imh.105208.

ABSTRACT

BACKGROUND: Fishermen face challenges that increase their vulnerability to oral and perioral diseases due to demanding working conditions, excessive environmental exposure and limited access to health care.

OBJECTIVE: This systematic review aims to map and synthesize the available evidence on the prevalence of oral and perioral diseases among fishermen.

MATERIAL AND METHODS: An extensive literature search was conducted in September 2024, including electronic databases, grey literature, and manual searches, without date or language restrictions, to identify observational studies evaluating the prevalence of oral and perioral diseases among fishermen. The risk of bias was assessed using the JBI critical appraisal checklist for studies reporting prevalence data. Meta- analyses were conducted to combine prevalence data from the included studies. The GRADE approach assessed the certainty of the evidence.

RESULTS: Thirteen analytical cross-sectional studies, involving 4,546 fishermen, of moderate methodological quality were found. The meta-analysis showed that the overall prevalence of oral and perioral diseases was around 49% (95% CI: 27-72%; 4,546 participants; low-quality evidence). Considering the most common diseases reported, the pooled prevalence of dental caries was 84%, leukoplakia 26%, and actinic cheilitis 35%. The most frequent risk factors identified as associated were smoking habits, alcohol consumption, and poor oral hygiene.

CONCLUSIONS: These findings should be recognized as a public health concern and addressed through preventive and informational policies in fishing communities and related organizations. Further studies using more reliable methods, larger sample sizes, and adequate management of confounding factors are necessary to confirm these findings.

PMID:41914194 | DOI:10.5603/imh.105208

Int Marit Health. 2026;77(1):31-38. doi: 10.5603/imh.105891.

ABSTRACT

BACKGROUND: Fishing is a physically demanding occupation that exposes workers to harsh environmentalconditions, awkward working postures and vibrations. These factors contribute to the development of musculoskeletal disorders (MSDs). This study aimed to determine the prevalence of MSDs as well as their associated factors among fishermen.

MATERIAL AND METHODS: This cross-sectional descriptive study was conducted among 576 male fishermen aged 20 to 58 years. Data were collected through clinical examinations and face-to-face interviews using the standardized Nordic Musculoskeletal Questionnaire.

RESULTS: The 7-day prevalence of MSDs among fishermen was 85.2%. The most affected anatomical sites were the lower back (79.5%), wrists/hands (71.0%), and shoulders (56.6%). Associated factors identified included age 40 and above, work experience of 10 years or more, being overweight/obese, alcohol abuse, and engine crew or fisherman vs. fishing boat captain.

CONCLUSIONS: Musculoskeletal disorders are a highly prevalent occupational health issue among fishermen. Preventive measures should focus on improving working conditions, promoting health education, conducting regular screenings, and strengthening occupational health services to reduce the risks and impacts of MSDs in this workforce.

PMID:41914193 | DOI:10.5603/imh.105891

Int Marit Health. 2026;77(1):23-30. doi: 10.5603/imh.106749.

ABSTRACT

BACKGROUND: Commercial fishing remains one of the most hazardous occupations globally, with smallscale fleets exhibiting persistent safety challenges. In Türkiye, fishing operations are characterized by low regulatory compliance, insufficient training, and fatigue-related risks.

OBJECTIVES: This study assessed occupational health and safety (OHS) compliance levels among Turkish fishing vessel crews and identified key predictors of safety outcomes across vessel size categories.

MATERIAL AND METHODS: A cross-sectional study was conducted (June-August 2018) across Türkiye’s Aegean, Marmara, and Black Sea regions, involving 356 crew members from 180 vessels. Data collection included structured questionnaires, observational checklists, and interviews. Analyses employed descriptive statistics, χ² tests, independent t-tests, and multiple linear regression (SPSS v26).

RESULTS: Of all participants, 38.8% reported at least one occupational accident in the past year. The most frequent injuries were cuts (12.9%), falls (9.3%), and equipment-related trauma (5.9%). The main contributing factors were the hasty work pace in the workplace (52.2%), inadequate training (28.9%), and fatigue due to long working hours (19.0%). PPE compliance was low at 18%, and only 27% of participants had received formal safety training. A significant association was found between vessel size and accident occurrence (χ² = 12.45, p = 0.002), with smaller vessels having a significantly higher accident risk than larger vessels. Workers involved in accidents reported longer working hours (M = 14.3, SD = 1.8) than their counterparts (M = 13.1, SD = 2.2; p < 0.001). Regression analysis identified formal training (β = 0.35, p < 0.001), education level (β = 0.21, p < 0.001), and vessel size (β = 0.14, p = 0.01) as significant predictors of OHS compliance (R² = 0.29).

CONCLUSIONS: Occupational health and safety compliance in Türkiye’s fishing sector remains inadequate, particularly for small-scale vessels. Prioritizing training expansion, work-hour regulations, and targeted support for high-risk fleets is essential.

PMID:41914192 | DOI:10.5603/imh.106749

Int Marit Health. 2026;77(1):1-12. doi: 10.5603/imh.108038.

ABSTRACT

BACKGROUND: Recreational diving creates risk for decompression sickness (DCS), which can occur in SCUBA diving even if current decompression algorithms are respected. The aim of this study was to identify the primary risk factors for decompression sickness in real-world regular recreational diving.

MATERIAL AND METHODS: This study analyzed 127,957 dives from 5,907 divers in the DAN DSL database (version 07/2024) to identify independent risk factors for DCS in recreational diving.

RESULTS: Decompression sickness was reported in 628 dives, yielding an incidence rate of 0.49%. The most critical predictor was the DAN Surface Supersaturation Gradient (DSSG), with significantly higher median values in DCS dives (0.866) compared to non-DCS dives (0.743, p < 0.001). Multivariate logistic regression identified 12 independent predictors of DCS, including DSSG (logarithmic effect on odds ratio [OR]), leading compartment, female gender (OR = 4.63), lower BMI classification (OR = 0.85), reduced number of repetitive dives (OR = 0.94 per dive), shorter surface intervals (OR = 0.96 per hour), greater gas count (OR = 2.87), exercise before diving (OR = 2.06), perceived thermal comfort (OR = 2.83), workload during dive (OR = 1.61), technical dive purpose (OR = 1.36), and pre-dive fatigue perception (protective, OR = 0.30). The model showed excellent discrimination with an area under the ROC curve of 0.910 and Somer’s D = 0.8287. Notably, dives using more than one gas mixture and those performed by females carried substantially increased DCS risk.

CONCLUSIONS: The study confirms that both physiological and operational factors influence DCS risk and provides a basis for personalized risk prediction tools in recreational diving.

PMID:41914190 | DOI:10.5603/imh.108038

J Pregnancy. 2026;2026(1):e8982438. doi: 10.1155/jp/8982438.

ABSTRACT

OBJECTIVES: The objectives of this study are to identify risk factors associated with failed labor induction in obese pregnancies at term and evaluate related maternal and neonatal outcomes.

METHODS: This cross-sectional study included obese pregnant women (BMI ≥ 30 kg/m²) who underwent labor induction at 37-41 weeks’ gestation in two academic hospitals in Surabaya, Indonesia, during 2023. Participants were classified into successful and failed induction groups. Maternal characteristics, induction-related factors, and pregnancy outcomes were compared. Multivariable logistic regression was used to identify independent risk factors for induction failure.

RESULTS: A total of 159 women were included, comprising 53 failed and 106 successful inductions. Failed induction was significantly associated with primiparity (adjusted odds ratio [aOR], 3.10; 95% CI, 1.46-6.58), Bishop score < 3 (aOR, 2.02; 95% CI, 1.14-3.55), and higher maternal weight gain during pregnancy (aOR per kg increase, 0.89; 95% CI, 0.84-0.95). Maternal weight gain demonstrated a moderate effect size (standardized mean difference, 0.62). Compared with successful induction, failed induction was associated with higher rates of severe preeclampsia (18.9% vs. 1.9%), cesarean delivery (100% vs. 5.7%), longer hospitalization, and lower 1-min Apgar scores. No significant differences were observed in 5-min Apgar scores, fetal growth restriction, congenital anomalies, or NICU admission.

CONCLUSIONS: In obese pregnancies at term, primiparity, unfavorable cervical status, and excessive gestational weight gain are independently associated with failed labor induction. These findings highlight the importance of optimized patient selection, cervical assessment, and anticipatory counseling to improve maternal and neonatal outcomes.

PMID:41914186 | DOI:10.1155/jp/8982438