Nevin Manimala

Sci Rep. 2025 Apr 21;15(1):13657. doi: 10.1038/s41598-025-98111-y.

ABSTRACT

Accurate traffic sign recognition (TSR) is critical for enhancing the safety and reliability of autonomous driving systems. This study proposes an optimized YOLOv5-based framework to address challenges such as small-scale detection, environmental variability, and real-time processing constraints. Three key innovations are introduced: (1) k-means++ clustering for anchor box optimization, achieving a 77.55% average IoU (vs. 75.95% for traditional k-means) to enhance small-target detection; (2) comprehensive comparative analysis of YOLOv5 variants (s/m/x), revealing precision-speed trade-offs (99.3-99.5% [email protected] vs. 32-45 ms inference time) for deployment flexibility; and (3) systematic hyperparameter tuning to maximize robustness across diverse scenarios. Leveraging the CCTSDB dataset (13,830 annotated images), experiments demonstrate the framework’s superiority: it attains 98.1% mean average precision (mAP), 98.6% recall, and 99.3% precision, outperforming Faster-RCNN and SSD by 5-8% in mAP while maintaining 45 FPS throughput. The YOLOv5s variant achieves optimal balance with 99.3% [email protected] and 32 ms per-image inference, validated through rigorous statistical analysis (Tukey HSD). Robust performance in challenging conditions (e.g., small sample, backlit sample, foggy scenes) is evidenced by detection confidence exceeding 0.90. These results highlight the framework’s applicability in latency-sensitive intelligent transportation systems.

PMID:40254650 | DOI:10.1038/s41598-025-98111-y

Sci Rep. 2025 Apr 20;15(1):13631. doi: 10.1038/s41598-025-95699-z.

ABSTRACT

Tuberculosis (TB) is a significant global public health concern. The incidence of extrapulmonary tuberculosis (EPTB) is increasing; however, comprehensive data on its epidemiological and clinical characteristics remain limited, especially among populations who are co-infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). This study aimed to assess the incidence and predictors of EPTB in patients co-infected with HIV or HCV in Egypt. We conducted a retrospective cohort study on patients infected with TB who are treated in Egyptian chest hospitals from January 1 to December 31, 2023. Patients were categorized into pulmonary TB (PTB) and EPTB. Clinical data, including HIV or HCV co-infection status, were analyzed to identify risk factors and comorbidities associated with EPTB. Multilevel logistic regression was employed to examine predictors of EPTB. Among 7,245 TB patients, 42.5% were diagnosed with EPTB. Determinant of EPTB were HIV-positive (OR = 0.46, 95% CI: 0.30-0.71, p < 0.001), being male (OR = 0.31, 95% CI: 0.27-0.35, p < 0.001 ), age (particularly children under 5 years) (OR = 4.75, 95% CI: 2.29-9.84, p < 0.001 ), urban residency (OR = 1.05, 95% CI: 0.87-1.27, p < 0.05), and comorbidities (OR = 0.59, 95% CI: 0.35-0.98, p < 0.05). The most common sites for EPTB were the lymph nodes (27.10%) and pleural cavity/effusion (24.60%). EPTB represents a substantial proportion of TB cases in Egypt, particularly among younger individuals and females. Despite the low percentage of HIV or HCV co-infection in EPTB cases, further analysis and diagnostic testing of undiagnosed patients are required. These findings underscore the need for targeted interventions and comprehensive care models for TB patients, especially in the context of HIV co-infection.

PMID:40254648 | DOI:10.1038/s41598-025-95699-z

Curr Environ Health Rep. 2025 Apr 21;12(1):19. doi: 10.1007/s40572-024-00469-0.

ABSTRACT

PURPOSE OF REVIEW: Studies examining the effects of social factors on the epigenome have proliferated over the last two decades. Social epigenetics research to date has broadly demonstrated that social factors spanning childhood adversity, to neighborhood disadvantage, educational attainment, and economic instability are associated with alterations to DNA methylation that may have a functional impact on health. These relationships are particularly relevant to brain-based health outcomes such as psychiatric disorders, which are strongly influenced by social exposures and are also the leading cause of disability worldwide. However, social epigenetics studies are limited by the many challenges faced by both epigenome-wide association studies (EWAS) and the study of social factors.

FINDINGS: In this manuscript, we provide a framework to achieve greater rigor and reproducibility in social epigenetics research. We discuss current limitations of the social epigenetics field, as well as existing and new solutions to improve rigor and reproducibility. Readers will gain a better understanding of the current considerations and processes that could maximize rigor when conducting social epigenetics research, as well as the technologies and approaches that merit attention and investment to propel continued discovery into the future.

PMID:40254641 | DOI:10.1007/s40572-024-00469-0

Nat Commun. 2025 Apr 20;16(1):3737. doi: 10.1038/s41467-025-58875-3.

ABSTRACT

Breast and cervical cancers are important causes of disability and premature death among women in Sub-Saharan Africa. Previous research has linked girls’ education to cancer service access. Here, we examine the causal effect of girls’ educational attainment on cancer screening practices by means of a natural experiment in Lesotho. In particular, we exploit variation in educational attainment among women that was introduced by an educational policy (a school-entry age cut-off). Data on awareness towards breast cancer, knowledge of Pap smear, breast self-exam, breast clinical exam, and having received a Pap smear is extracted from the Lesotho Demographic and Health Surveys 2009-10 and 2014 (N = 7971). Each additional year of schooling caused by the education policy increases awareness of breast cancer by 4.7 percentage points (p = 0.014, 95% Confidence Interval [CI]: 1.0, 8.5), awareness of Pap smear by 5.9 percentage points (p = 0.001, 95% CI: 2.3, 9.5), and engagement in Pap smear by 3.5 percentage points (p = 0.004, 95% CI: 1.1, 5.8). We found no statistically significant effects on breast self-exam and breast clinical exam.

PMID:40254639 | DOI:10.1038/s41467-025-58875-3

Sci Rep. 2025 Apr 20;15(1):13644. doi: 10.1038/s41598-025-97703-y.

ABSTRACT

Susceptibility of bats to white-nose syndrome (WNS), a lethal disease caused by the fungus Pseudogymnoascus destructans (Pd), may be influenced by the amount of activity outside hibernacula during the winter. We tested the effects of hibernaculum type (aboveground or subterranean) and Pd status (positive or negative) on winter activity of tricolored bats (Perimyotis subflavus) in the southeastern USA along with the effects of ambient temperature, precipitation, and stage of hibernation. We placed acoustic detectors at the entrances of 13 hibernacula (4 aboveground and Pd-positive, 4 aboveground and Pd-negative, 4 subterranean and Pd-positive, and 1 subterranean and Pd-negative) during winter 2020-21 and 2021-22. While neither hibernaculum type nor Pd status alone predicted probability of activity or levels of activity, these factors interacted with temperature, precipitation, and stage of the hibernation period. Activity increased at a greater rate with temperature and time since the onset of hibernation in aboveground and Pd-negative sites and decreased at a faster rate in response to precipitation. Our results suggest that tricolored bats using aboveground hibernacula such as culverts or bridges may be less susceptible to WNS due to greater nighttime activity. However, use of these structures may have other costs such as higher freezing and predation risks.

PMID:40254625 | DOI:10.1038/s41598-025-97703-y

Sci Rep. 2025 Apr 21;15(1):13654. doi: 10.1038/s41598-025-96670-8.

ABSTRACT

Although COVID-19 is no longer a global public health threat, its consequences persist, with long COVID affecting at least 10% of patients and manifesting in various organ systems. National and international health agencies promoted vaccination to enhance population immunity, prioritizing healthcare personnel due to their high occupational risk. In a previous study, we found that the risk of SARS-CoV-2 transmission among dental teams in Germany was not higher than in the general population. This follow-up investigation aims to assess the vaccination status and the prevalence and severity of long COVID symptoms among dental teams in Germany. As part of a follow-up investigation involving the original cohort, 267 team members from 186 German dental practices previously included in the initial study completed an online questionnaire. The questionnaire covered three topics: (1) vaccination status, (2) confirmed COVID-19 diagnosis, and (3) self-reported long COVID symptoms. One hundred and seventy-two dentists (64.4%), 74 dental assistants (27.7%) and 21 dental hygienists (7.9%) completed the questionnaire. In total, 245 participants (91.8%) were at least once vaccinated. A COVID-19 infection after January 1st 2021 was reported by 146 (54.7%) participants, of which 33 participants (22.6%) suffered from long COVID symptoms. Our results showed lower vaccination rates among dental auxiliary personnel compared to dentists (95.9% vs. 84.2%). Individuals with long COVID symptoms were more often dental assistants (48.5% vs. 29.2%) or dental hygienists (15.2% vs. 8.0%) than dentists (36.4% vs. 62.8%) compared to the group not reporting long COVID symptoms (p = 0.025). In addition, it is unlikely that dental healthcare personnel are more prone to experiencing more severe symptoms compared to the general population. Vaccination against SARS-CoV-2 is likely to help against symptoms of long COVID.

PMID:40254623 | DOI:10.1038/s41598-025-96670-8

Sci Rep. 2025 Apr 20;15(1):13627. doi: 10.1038/s41598-025-97025-z.

ABSTRACT

Sickness absence (SA) changed in various occupations during the COVID-19 pandemic. The aim was to investigate the prevalence of all-cause sickness absence (SA) during the COVID-19 pandemic in relation to in the preceding years, as well as factors associated with all-cause SA and SA due to COVID-19 and COVID-like diagnoses during the COVID-19 pandemic among blue-collar workers in the retail and wholesale industry. A population-based longitudinal cohort study using microdata linked from nationwide registers in Sweden. All 297 378 blue-collar employees aged 18-67 years in wholesale and retail in 2019 were followed during 2016-2021 regarding SA in spells > 14 days. Yearly prevalence rates were calculated for all-cause SA in sociodemographic and occupational groups. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for all-cause SA and SA due to COVID-19 or COVID-like diagnoses in 2020 and 2021. The annual prevalences of SA were 7.5-8% in 2016-2018, 10% in 2020, and 9% in 2021. The prevalence of SA due to COVID-19 or COVID-like diagnoses was 2.1% in 2020 and 1.6% in 2021. The OR was higher in the older age groups (OR age 55-64 = 2.38, 95% CI 2.20-2.57 compared to age 25-34). There were few significant occupational differences, however, warehouse and terminal staff had a higher OR (1.37, 1.27-1.48) than sales assistants, daily goods. While SA rates increased during the COVID-19 pandemic, the distribution of SA between sociodemographic or occupational groups did not change markedly. The distribution of SA due to COVID-19 and COVID-like diagnoses was similar to all-cause SA.

PMID:40254621 | DOI:10.1038/s41598-025-97025-z

BMC Urol. 2025 Apr 21;25(1):96. doi: 10.1186/s12894-025-01781-z.

ABSTRACT

PURPOSE: Nephrectomy for inflammatory renal conditions (IRCs) presents comparable challenges irrespective of the surgical approach. This meta-analysis evaluates whether laparoscopic nephrectomy (LN) is safer than open nephrectomy (ON) for managing IRCs, including xanthogranulomatous pyelonephritis (XGP), pyonephrosis, and renal tuberculosis.

METHODS: Following PRISMA/Cochrane guidelines, we systematically reviewed studies comparing LN and ON in adults with IRCs. Inclusion required direct LN vs. ON comparisons and perioperative outcomes. Exclusions included pediatric cohorts and studies conflating converted LN cases with ON groups.

RESULTS: From 16 identified studies, 13 met the inclusion criteria, encompassing 868 patients undergoing nephrectomy for IRCs. Of these, 398 (45.9%) underwent ON, and 470 (54.1%) underwent LN. Compared to ON, LN demonstrated a statistically significant (28%) reduction in overall-complications (RR = 0.72, 95% CI [0.6-0.86]; p = 0.0004; low-heterogeneity) and non-significant reduction in high-grade complications (RR = 0.65, 95% CI [0.4-1.06]; p = 0.09; low-heterogeneity), with moderate certainty of evidence. LN was also associated with 53% fewer blood transfusions (post-sensitivity analysis (RR = 0.47, p < 0.0001; low certainty), significant blood loss reduction in XGP-patients (after subgroup analyses MD = -130.8 mL; 95% CI [-203.35 to -58.21]; low certainty), and shorter hospital stays (PMD = -3.04 days; p < 0.00001; very low certainty), albeit with longer operative times (PMD = + 39.05 min; p = 0.03; very low certainty).

CONCLUSION: LN is a safer alternative to ON for IRCs, offering fewer complications, shorter hospitalization, and reduced transfusions despite prolonged operative times. Surgeon expertise and patient-specific selection are critical to optimizing outcomes.

PMID:40254599 | DOI:10.1186/s12894-025-01781-z

BMC Oral Health. 2025 Apr 20;25(1):605. doi: 10.1186/s12903-025-05939-x.

ABSTRACT

OBJECTIVES: More time is often needed for adult orthodontic patients compared with juvenile counterparts due to lower tissue vitality. In some cases, the prolonged orthodontic treatment may cause a series of problems, such as enamel demineralization, dental caries, periodontitis and root resorption. Therefore, we aimed to accelerate tooth movement to avoid various adverse reactions by 3D-printing assisted micro-osteoperforations (MOPs) in difficult orthodontics cases.

METHODS: Twenty-eight adult patients (28.3 ± 3.4 years) with slow tooth movement after extraction of bilateral maxillary first premolars were included. The scheme of 3D-printing assisted MOPs was designed to perform bone punctures in the mesial and distal sides of canines.

RESULTS: The average speed of the retraction of canines was 1.02 ± 0.41 mm per month after MOPs and significantly faster than that before the MOPs, 0.34 ± 0.16 mm per month (P < 0.05). Moreover, the evaluation of side effects including root resorption, periodontal damage did not reach statistical difference and pain level was acceptable generally.

CONCLUSION: MOPs assisted by 3D-printing could significantly accelerate tooth movement while achieving greater precision, without notably increasing side effects.

TRIAL REGISTRATION: ChiCTR2100044685, date of registration: 25/03/2021.

PMID:40254596 | DOI:10.1186/s12903-025-05939-x

BMC Emerg Med. 2025 Apr 20;25(1):69. doi: 10.1186/s12873-025-01191-2.

ABSTRACT

BACKGROUND: Cancer-related emergencies are a significant challenge for healthcare systems globally, including Jordan. Effective triage is critical in ensuring timely and accurate prioritization of care, especially for surgical cancer patients requiring urgent intervention. However, under-triage-misclassification of high-acuity patients into lower urgency categories-can lead to significant delays and worsened outcomes. Despite the recognized importance of accurate triage, limited research has evaluated its impact on cancer patients in Jordan, particularly those requiring surgical care.

OBJECTIVES: This study aimed to evaluate the timeliness and prioritization of care for cancer patients admitted through the emergency department (ED) in Jordan. The specific objectives were to examine the association between under-triage and treatment delays and assess its impact on key outcomes, including time to physician assessment, time to treatment, and hospital length of stay.

METHODS: A retrospective cohort design was used to analyze data from 481 cancer patients admitted through the ED in four governmental hospitals across Jordan. Two cohorts were established: surgical cancer patients requiring emergency interventions and non-surgical cancer patients presenting with other oncological emergencies. Triage accuracy was assessed using the Canadian Triage and Acuity Scale (CTAS), and under-triage was identified when patients requiring high urgency care (CTAS I-III) were misclassified into lower urgency categories (CTAS IV-V). Data were collected from electronic health records and analyzed using multiple linear regression to evaluate the association between under-triage and treatment outcomes.

RESULTS: The majority of patients were elderly, with a mean age of 62.6 years (± 10.7), and a significant proportion presented with advanced-stage cancer (83.4% in stages III and IV). Surgical patients frequently exhibited severe symptoms such as acute pain (51.6%) and respiratory discomfort (41.1%). Under-triage rates were 44.1% for surgical patients and 39.4% for non-surgical patients. Among surgical patients, under-triage significantly delayed time to physician assessment (β = 34.9 min, p < 0.001) and time to treatment (β = 68.0 min, p < 0.001). For non-surgical patients, under-triage delays were even greater, with prolonged physician assessment times (β = 48.6 min, p < 0.001) and ED length of stay (β = 7.3 h, p < 0.001). Both cohorts experienced significant increases in hospital length of stay (surgical: β = 3.2 days, p = 0.008; non-surgical: β = 3.2 days, p < 0.001).

CONCLUSION: Under-triage in Jordanian EDs is strongly associated with significant delays in care for both surgical and non-surgical cancer patients, highlighting systemic gaps in acuity recognition and triage processes. These findings underscore the need for targeted interventions to improve triage accuracy, particularly through oncology-specific training and the integration of evidence-based tools like SIRS criteria. Enhancing ED processes for cancer patients is crucial to reducing delays, optimizing resource allocation, and improving clinical outcomes in this vulnerable population.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40254595 | DOI:10.1186/s12873-025-01191-2