Nevin Manimala

BMC Public Health. 2025 Nov 24. doi: 10.1186/s12889-025-25690-w. Online ahead of print.

ABSTRACT

BACKGROUND: Road traffic accidents (RTAs) are a major public health concern, disproportionately affecting low- and middle-income countries. Despite having fewer vehicles per capita, Africa experiences the highest global road traffic fatality rates. This study examines demographic, temporal, and geographic patterns of fatal RTAs in Cape Town to inform targeted safety interventions.

METHODS: A retrospective analysis of Western Cape Government Health and Wellness Emergency Medical Services (WCGHW EMS) data (January 2021-May 2024) was conducted. Data included patient demographics, location, time, and accident type. Geospatial mapping using QGIS identified hotspots, and statistical analyses assessed relative risk and mortality trends.

RESULTS: Of 784 RTA cases, 167 resulted in fatalities. Males accounted for 70.7% of deaths, and pedestrians comprised 65.3% of fatalities. Nighttime fatalities (51.5%) were significantly higher, with hotspot areas showing a two-fold increased mortality risk (RR = 2.09, 95% CI: 1.61-2.72, p < 0.001).

CONCLUSION: This study highlights demographic and pedestrian vulnerabilities, the heightened risk of nighttime fatalities, and the geographic concentration of fatal RTAs in Cape Town. Findings underscore the urgent need for improved pedestrian infrastructure, enhanced street lighting, and optimised emergency medical response strategies. Targeted safety interventions in high-risk areas can significantly reduce RTA fatalities. Further research should explore behavioural and environmental factors over longer timeframes to inform policy and practice.

PMID:41276801 | DOI:10.1186/s12889-025-25690-w

Br J Surg. 2025 Nov 6;112(11):znaf251. doi: 10.1093/bjs/znaf251.

ABSTRACT

INTRODUCTION: In recent years there have been a plethora of new endovascular devices have entered the market, including paclitaxel (PTX) drug-coated balloons (DCB) and drug-eluting stents (DES) for treating patients with chronic limb-threatening ischaemia (CLTI). There have been concerns that the use of PTX is associated with increased all-cause mortality rate in this patient population.

METHODS: In the BASIL-3 trial (ISRCTN14469736) UK patients with CLTI were randomized (1:1:1) to receive femoro-popliteal (FP) plain balloon angioplasty (PBA; with or without bailout bare metal stenting (BMS), DCB angioplasty (DCBA) (with or without BMS), or primary DES. Here, data from the DCBA and DES arms have been pooled into a single ‘drug technologies’ (DT) group and compared with PBA ± BMS. The primary outcome was overall survival (OS). Secondary outcomes included amputation-free survival (AFS), major amputations, major adverse limb events, major adverse cardiovascular events, reinterventions, and 30-day mortality and morbidity rates.

RESULTS: Four hundred and eighty-one participants were randomized (PBA: n = 160; DT: n = 321). At a median follow-up in survivors of 5.6 years, OS was similar between the pooled DT and PBA groups (adjusted hazard ratio (HR): 0.83; 95% c.i.: 0.64 to 1.07). There was no evidence of a statistically significant difference in AFS between the groups (adjusted HR: 0.84; 95% c.i.: 0.66 to 1.06), or other secondary outcomes.

CONCLUSIONS: This further pooled analysis of the BASIL-3 RCT does not support the notion that the use of drug-eluting technologies, when compared to plain balloon angioplasty, increases all-cause mortality rate, or has other clinically important adverse effects, when used in patients with CLTI.

PMID:41276786 | DOI:10.1093/bjs/znaf251

Sports Med Open. 2025 Nov 23;11(1):145. doi: 10.1186/s40798-025-00933-7.

ABSTRACT

BACKGROUND: Intermittent hypoxia (IH) has emerged as a promising strategy to enhance physical performance by eliciting adaptive responses across cardiovascular, respiratory, and muscular systems. Various IH protocols have been applied in both trained and untrained individuals to improve aerobic capacity, strength, and repeated sprint ability. However, the growing number of systematic reviews and meta-analyses (SRs/MAs) has led to heterogeneous conclusions due to variability in populations, protocols, and outcome measures. This umbrella review aimed to synthesize and critically appraise the available SRs/MAs on the effects of IH protocols on physical performance across different fitness levels.

METHODS: A systematic search, aligned with the PRIOR (Preferred Reporting Items for Overviews of Reviews) guidelines, was conducted across seven electronic databases (PubMed/MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, Scopus, Embase, PsycINFO, and SciELO) from inception to June 2025. Eligible studies included systematic reviews (SRs) with or without meta-analyses (MAs) or network meta-analyses (NMAs) evaluating the effects of intermittent hypoxia protocols on physical performance. Methodological quality was assessed using the AMSTAR-2 tool.

RESULTS: A total of 22 systematic reviews (14 with meta-analyses, 3 with network meta-analyses) analyzing 487 primary studies and 5,333 participants were included. Intermittent hypoxia (IH) protocols improved both aerobic and anaerobic performance, as well as muscular strength. Live high-train low (LHTL) and live low-train high (LLTH) protocols consistently enhanced V̇O₂max, especially when combined with sea-level training. Anaerobic-focused strategies like repeated sprint training in hypoxia (RSH) and RSH induced by voluntary hypoventilation at low lung volume (RSH-VHL) led to improvements in sprint-fatigue resistance and glycolytic capacity. Intermittent hypoxic interval training (IHIT) and high-intensity interval training (HIIT) under hypoxia showed robust aerobic benefits. However, the magnitude of these effects varied depending on the type of protocol, training status, and hypoxic dose.

CONCLUSION: IH is an effective and adaptable strategy to improve aerobic and anaerobic performance, as well as to enhance muscle strength and hypertrophy. These benefits often occur without consistent hematological changes. Future studies should focus on individualized approaches, standardization of terminology, and precise quantification of both hypoxic exposure and training load to optimize outcomes and ensure reproducibility.

REVIEW REGISTRATION: This overview was registered on the International Database of Systematic Review Protocols (PROSPERO ID: CRD42024465481).

PMID:41276779 | DOI:10.1186/s40798-025-00933-7

J Plant Res. 2025 Nov 23. doi: 10.1007/s10265-025-01681-1. Online ahead of print.

ABSTRACT

Reproductive interference is a negative interspecific interaction that can drive mutually exclusive distributions of closely related species. While recent research indicates that reproductive interference in plants frequently occurs during pollen-pistil interactions, comprehensive descriptions of these interactions are scarce. Understanding the mechanisms underlying reproductive interference requires studies integrating empirical observations with interaction analyses. This study investigates pollen-pistil interactions between three Veronica species recently observed to exhibit asymmetric reproductive interference.Our experiments revealed similar pollen tube behavior in V. polita var. lilacina and V. cymbalaria pistils, irrespective of whether they were pollinated with conspecific or V. persica pollen. Conversely, in V. persica pistils, the number of pollen tubes significantly decreased following heterospecific pollination compared to conspecific pollination. Furthermore, half of the pollen grains on V. persica stigmas, presumably heterospecific pollen grains, occasionally appeared non-luminous under the fluorescence microscope after mixed pollination. Conspecific pollen tubes appeared to grow faster within V. persica pistils; however, statistical analysis did not support this trend.These results suggest that V. polita var. lilacina and V. cymbalaria pistils exhibit limited discrimination against V. persica pollen, resulting in ovule discounting by the heterospecific pollen. This mechanism explains the empirical observation that these species experience reduced seed set after mixed pollination, even when conspecific pollen is applied first. In contrast, V. persica pistils demonstrate a degree of discrimination between conspecific and heterospecific pollen, particularly when conspecific pollen arrives on the stigma prior to heterospecific pollen. This selectivity accounts for the empirical findings that V. persica exhibits reduced seed set only when surrounded by V. polita var lilacina or after mixed pollination with V. cymbalaria pollen preceding conspecific pollen.

PMID:41276765 | DOI:10.1007/s10265-025-01681-1

J Racial Ethn Health Disparities. 2025 Nov 23. doi: 10.1007/s40615-025-02750-w. Online ahead of print.

ABSTRACT

Gentrification is a process of neighborhood change characterized by capital investment in historically disinvested neighborhoods and an influx of residents of higher socioeconomic status. While gentrification generates neighborhood improvements that benefit newcomers, it has been recognized as a public health issue characterized by inequities in housing, economic, and health opportunities for long-term residents, specifically low-income and Black populations, who are at high risk of physical and social displacement. Thus, this cross-sectional ecological study based in Allegheny County, Pennsylvania, sought to (1) identify the relationships between gentrification status and three neighborhood-level indices representing housing conditions, socioeconomic conditions, and environmental conditions and (2) determine whether the rate of the Black population change from 2010 to 2020 modified these relationships. We used separate logistic regression models for three neighborhood-level indices to quantify the relationship between each index and gentrifying census tracts compared with census tracts that were eligible for gentrification but did not gentrify. Gentrifying census tracts were statistically associated with stronger housing markets (i.e., higher housing value) (OR = 0.66; 95% CI: 0.57-0.77), lower levels of community need (OR = 0.42; 95% CI: 0.27-0.65), and lower levels of environmental burden (OR = 0.62; 95% CI: 0.47-0.81) than nongentrifying census tracts were. Because higher index values indicate worse outcomes, these results suggest that gentrifying tracts had relatively better housing market conditions, lower community need, and reduced environmental burden compared to nongentrifying tracts. The rate of Black population change had a marginal interaction effect with each of the indices.

PMID:41276760 | DOI:10.1007/s40615-025-02750-w

J Nurs Scholarsh. 2025 Nov 23. doi: 10.1111/jnu.70056. Online ahead of print.

ABSTRACT

PURPOSE: Assess US registered nurse genomic competency.

DESIGN: Administered the Genetics and Genomics Nursing Practice Survey (GGNPS).

METHODS: GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utilization in nursing practice. Distributed by the American Nurses Association via email and online to US registered nurses. Results are analyzed using descriptive statistics and compared to 2010 data.

RESULTS: 1065 registered nurses responded. Most (41%) were Master’s prepared, actively seeing patients (51%) and 66% considered it very important to learn more about genomics. Most (55%) reported their genomic knowledge was poor yet 51% reported a patient initiated a genetic discussion with them in the past 3 months. 66% completed all knowledge score items with a median score of 9/12, no change from 2010. Only 26% had heard of the Essential Competencies. Most reported no genomic curricular content (64%); had not attended a genomic course since licensure (64%); intended to learn more about genomics (70%); and would attend a course on their own time (79%).

CONCLUSIONS: Nurses felt genomics was important but have capacity deficits. Despite genomic discoveries and evidence-based practice guidelines that impact healthcare quality and safety, 20 years after the Genomic Competencies were established (2005) nursing genomic practice capacity remains low.

CLINICAL RELEVANCE: Genomics is critical to the safe, quality nursing practice regardless of the level of academic training, clinical role, or specialty.

PMID:41276756 | DOI:10.1111/jnu.70056

Anim Cogn. 2025 Nov 23. doi: 10.1007/s10071-025-02028-y. Online ahead of print.

ABSTRACT

Studying Theory of Mind in non-verbal populations requires designing tasks that address the distinction between responding based on directly perceivable cues and additionally inferring others’ mental states. We designed and pre-registered an auditory version of a non-verbal change-of-location task, to investigate whether dogs are sensitive to a human communicator’s mental states about the location of food. With control conditions we ruled out alternative cognitive processes such as associative learning. Dogs (N = 240) could witness that food was hidden first in one opaque bucket (A) and then relocated to a second opaque bucket (B) by an experimenter. Before being allowed to retrieve the food from one of the buckets, dogs received a misleading suggestion (A) from the communicator, who could not see the scene. In all conditions, the communicator could hear food being hidden in A, due to the presence of bells on the lid of this bucket. We manipulated whether she could also hear that food was removed from A and relocated to B (true belief) or not (silent bells on B, leading to her false belief). Importantly, in both conditions the communicator behaved identically (present in the room, suggesting A). Dogs’ responses were not statistically different from those of a previous study using a similar change-of-location task in the visual domain (Lonardo et al. 288(1955), 2021, https://doi.org/10.1098/rspb.2021.0906). Dogs’ choices in the present study, however, did not differ significantly across conditions, suggesting that any auditory perspective-taking ability they might possess did not have a sufficiently large effect to be detected in this study.

PMID:41276726 | DOI:10.1007/s10071-025-02028-y

Odontology. 2025 Nov 23. doi: 10.1007/s10266-025-01260-9. Online ahead of print.

ABSTRACT

We evaluated the effect of supplementary instrumentation on the removal of gutta-percha and compared the efficacy of three file systems with different metallurgical properties via micro-computed tomography (micro-CT). Forty-two moderately curved mandibular molars were selected and divided into 3 groups (n = 14): group-PTG: ProTaper Gold, group-PTN: ProTaper Next, and group-VB: Vortex Blue. Only mesial roots with Vertucci type-IV configuration were included. Canals were instrumented and obturated with bioceramic sealer. Retreatment was performed using a retreatment file system, and supplementary instrumentation was completed according to experimental groups: ProTaper Next X4 (40/06), ProTaper Gold 40/06, and Vortex Blue 40/06. Initial, second (after using the retreatment file system), and final (after supplementary instrumentation) micro-CTs were obtained (resolution 85 kV, 118 µA, and 13.6 µA pixel size), and residual gutta-percha at apical, middle, and coronal thirds was calculated. One-way ANOVA and Student’s t test were performed for statistical analysis. While the first and second micro-CT values demonstrated a statistical difference (p < 0.05), there was no difference between the second and final micro-CT values. No differences were detected between group-PTN (96.89-98.32%), group-PTG (95.36-98.51%), and group-VB (%96.96-%99.38). Residual gutta-percha volumes were similar in mesiobuccal and mesiolingual canals. Supplementary instrumentation did not decrease the amount of residual gutta-percha. Increasing the initial apical size by three sizes removed 98.18% to 99.38% of gutta-percha. ProTaper Next, ProTaper Gold, and Vortex Blue showed similar effects. In the apical third of mesiobuccal, ProTaper Gold and Vortex Blue eliminated gutta-percha more effectively than ProTaper Next.

PMID:41276710 | DOI:10.1007/s10266-025-01260-9

Discov Oncol. 2025 Nov 23. doi: 10.1007/s12672-025-04074-x. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to identify clinically relevant molecular signatures and biomarkers associated with post-translational modifications (PTMs) and RNA methylation in clear cell renal cell carcinoma (ccRCC) by integrating multi-omics data to elucidate tumorigenesis mechanisms and tumor microenvironment dynamics for potential diagnostic and therapeutic advancements.

METHODS: We analyzed bulk RNA-sequencing data from five GEO datasets, GSE16449, GSE46699, GSE53000, GSE53757, and GSE66272, with batch-effect correction using the sva package and single-cell RNA-seq data processed via Seurat v4 with Harmony integration. Differential expression analysis using limma identified PTM- and methylation-related gene signatures. Functional enrichment using clusterProfiler and Weighted Gene Co-expression Network Analysis (WGCNA) revealed key modules linked to 20 PTM types and four RNA methylation patterns, m1A, m5C, m6A, and m7G. Machine learning using LASSO, SVM, and Random Forest, along with SHAP-based random forest modeling, selected and evaluated biomarkers. Immune infiltration was assessed via ssGSEA, and consensus clustering defined molecular subtypes. Statistical analyses using Wilcoxon and Kruskal-Wallis tests with FDR correction ensured robustness.

RESULTS: We identified 2,779 differentially expressed genes, including 14 significant PTM and methylation signatures including 11 PTMs, 3 methylation types, enriched in PI3K-Akt signaling and immune response pathways. WGCNA revealed four disease-associated modules tied to PTMs and RNA methylation. Single-cell analysis delineated 16 cell types, with T cells dominant in tumors and enhanced cell-cell interactions in high-modification groups. Machine learning identified PDIA3, STT3A, and USP4 as core biomarkers, with SHAP confirming STT3A’s predictive strength. Biomarkers showed elevated expression in ccRCC, correlating with dendritic and T cell infiltration. Consensus clustering defined two subtypes: C2 exhibited higher PTM/methylation-related gene expression, oncogenic pathway enrichment, and lower immune infiltration compared to C1.

CONCLUSION: This integrative multi-omics framework identifies PDIA3, STT3A, and USP4 as key biomarkers linked to PTMs and RNA methylation, delineating two molecular subtypes. These findings enhance understanding of ccRCC’s molecular and immune landscape, offering insights for improved diagnostic and therapeutic strategie.

PMID:41276708 | DOI:10.1007/s12672-025-04074-x

Aging Clin Exp Res. 2025 Nov 23. doi: 10.1007/s40520-025-03260-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Sarcopenia, characterized by a progressive loss of skeletal muscle mass and function, significantly affects older adults, particularly those with cancer. Although sarcopenia’s negative influence on quality of life (QoL) is acknowledged, data on its specific impact among older hospitalized oncology patients remain limited. The aim of the present study was to assess the health-related quality of life in older patients (≥ 65 years) diagnosed with gastrointestinal cancer using the SarQoL^® questionnaire and to analyze the association between weight loss and functioning across individual quality of life domains.

METHODS: This cross-sectional study included 97 consecutive patients (≥ 65 years) diagnosed with gastrointestinal cancer, hospitalized at the University Hospital in Krakow between June and September 2023. Participants completed the SarQoL^® questionnaire, assessing QoL across seven domains: physical and mental health, locomotion, body composition, functionality, activities of daily living, leisure activities, and fears. Nutritional status was evaluated using Nutritional Risk Screening 2002 (NRS-2002).

RESULTS: Patients had moderate impairment in overall QoL (mean SarQoL^® score: 61.7 ± 15.4/100). Lowest scores were observed in leisure activities (55 points), while highest scores occurred in fears (83 points). A significant but weak inverse correlation was observed between body weight and functionality (r = -0.225 ; p < 0.05) and fears domains (r = -0.255 ; p < 0.05), indicating higher QoL scores with lower body weight. Notably, patients with higher NRS scores paradoxically reported better functionality (r = 0.213 ; p < 0.05). Additionally, subjective physical weakness strongly correlated with mobility limitations and fatigue during walking (p < 0.001).

CONCLUSIONS: Sarcopenia substantially impairs QoL in older oncology patients, especially regarding leisure and functionality domains. The SarQoL^® questionnaire is effective in identifying nuanced impacts of sarcopenia on QoL. Early nutritional and rehabilitative interventions tailored to these insights could significantly enhance patient care and QoL outcomes.

PMID:41276697 | DOI:10.1007/s40520-025-03260-9