Nevin Manimala

Cancer Causes Control. 2025 Jan 4. doi: 10.1007/s10552-024-01950-9. Online ahead of print.

ABSTRACT

PURPOSE: Historical redlining, a 1930s-era form of residential segregation and proxy of structural racism, has been associated with breast cancer risk, stage, and survival, but research is lacking on how known present-day breast cancer risk factors are related to historical redlining. We aimed to describe the clustering of present-day neighborhood-level breast cancer risk factors with historical redlining and evaluate geographic patterning across the US.

METHODS: This ecologic study included US neighborhoods (census tracts) with Home Owners’ Loan Corporation (HOLC) grades, defined as having a score in the Historic Redlining Score dataset; 2019 Population Level Analysis and Community EStimates (PLACES) data; and 2014-2016 Environmental Justice Index (EJI) data. Neighborhoods were defined as redlined if score ≥ 2.5. Prevalence quintiles of established adverse and protective breast cancer factors relating to behavior, environment, and socioeconomic status (SES) were used to classify neighborhoods as high-risk or not. Factor analysis grouped factors into domains. Overall and domain-specific scores were calculated for each neighborhood according to historical redlining status. Percent difference in score by historical redlining was used to assess differences in average scores, with Wilcoxon-Mann-Whitney test used to estimate significance. Kappa statistic was used to estimate concordance between historical redlining status and high-risk status. Heatmaps of scores were created to compare spatial clustering of high-risk factors to historical redlining.

RESULTS: We identified two domains: (1) behavior + SES; (2) healthcare. Across the US, redlined neighborhoods had significantly more breast cancer factors than non-redlined (redlined neighborhoods = 5.41 average high-risk factors vs. non-redlined = 3.55 average high-risk factors; p < 0.0001). Domain-specific results were similar (percent difference for redlined vs. non-redlined: 39.1% higher for behavior + SES scale; 23.1% higher for healthcare scale). High-scoring neighborhoods tended to spatially overlap with D-grades, with heterogeneity by scale and region.

CONCLUSION: Breast cancer risk factors clustered together more in historically redlined neighborhoods compared to non-redlined neighborhoods. Our findings suggest there are regional differences for which breast cancer factors cluster by historical redlining, therefore interventions aimed at redlining-based cancer disparities need to be tailored to the community.

PMID:39755825 | DOI:10.1007/s10552-024-01950-9

Sci Rep. 2025 Jan 4;15(1):747. doi: 10.1038/s41598-024-84986-w.

ABSTRACT

The preservation of the original configurations of root canals during endodontic preparation is crucial for treatment success. Nickel-titanium (NiTi) rotary systems have been refined to optimize canal shaping while minimizing iatrogenic errors. This study aimed to evaluate and compare the shaping efficacy of the novel R-Motion (RM) and the established WaveOne Gold (WG) systems using micro-computed tomography (micro-CT). Twenty-four mesial canals of 12 double-rooted extracted mandibular first molars were randomly assigned to either the RM or WG groups, with the mesiobuccal (MB) and mesiolingual (ML) canals allocated accordingly. Root canals were prepared following the manufacturer’s protocols. In the RM group, crown-down technique up to a 25/0.06 taper was employed. For the WG group, the preparation was completed with a WG primary file (25/0.07 taper). Specimens were scanned using micro-CT scans before and after instrumentation to establish baseline and post-instrumentation datasets. The following parameters were evaluated, and values were calculated to compare the shaping ability of the two files: percentage of untouched canal walls, changes in surface area, canal volume, dentin thickness, canal angulation, structure model index, canal transportation, and centering ability ratio. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY), with a statistical significance set at P ≤ 0.05. Micro-CT analysis demonstrated comparable untouched canal surface areas and changes in surface area and volume between both RM and WG systems. Both systems effectively straightened canal curvature without significant differences in canal angulation. The RM files exhibited a statistically lower reduction in dentin thickness, indicating better preservation of structural integrity. Both RM and WG files displayed similar effective shaping abilities. However, RM caused less dentin removal and canal transportation. Thus, RM is recommended for its ability to balance effective canal shaping with structural preservation in a conservative manner.

PMID:39755800 | DOI:10.1038/s41598-024-84986-w

Sci Rep. 2025 Jan 4;15(1):837. doi: 10.1038/s41598-024-85047-y.

ABSTRACT

Benign paroxysmal vertigo (BPV) is a common cause of dizziness, and some patients are comorbid with psychiatric disorders such as depression, requiring intervention with antidepressants. However, the causal association between BPV, depression and antidepressants has not been clearly established. We used two-sample bidirectional Mendelian randomization (MR) to analyze the causal association between BPV, depression, and antidepressants. From a Finnish database, 43,280 patients with depression and 329,192 controls, and 106,785 patients with antidepressants and 88,536 controls were selected. Independent single nucleotide polymorphisms (SNPs) for depression and antidepressants were used as instrumental variables (IVs) with genomic significance (p < 5 × 10^-8). Similarly, genome-wide association study (GWAS) data for BPV were selected from a Finnish database consisting of 8280 cases and 359,094 controls. Afterwards, a two-sample MR study was performed using R’s Two Sample MR and MR-PRESSO software packages. The multiplicity and heterogeneity of the data, as well as the effect of individual SNPs on the results were investigated. The main statistical analyses were weighted median, weighted mode, MR-Egger and weighted inverse variance weighting (IVW) for random effects. Finally, we identified associations between BPV, antidepressants and depression. Four outliers (rs3773087, rs4619804, rs62099231, rs7192848) were found to be associated with depression. After removing the outliers, the statistics showed no heterogeneity (p > 0.05) and horizontal pleiotropy (p > 0.05). Antidepressants were also found to have a random effect IVW (β = 0.440; p = 9.692 × 10^-6; OR = 1.553; 95% CI 1.278-1.887). The inverse MR random effects IVW results showed a causal association between BPV and antidepressants (β = 0.051; p = 0.045; OR = 1.052; 95% CI 1.001-1.1066). In conclusion, there was a significant causal association between antidepressants and BPV at the genetic level. Clinicians should pay attention to patients with BPV combined with depressive disorders and develop timely interventions.

PMID:39755797 | DOI:10.1038/s41598-024-85047-y

Sci Rep. 2025 Jan 4;15(1):834. doi: 10.1038/s41598-024-84522-w.

ABSTRACT

In modern knee arthroplasty, surgeons increasingly aim for individualised implant selection based on data-driven decisions to improve patient satisfaction rates. The identification of an implant design that optimally fits to a patient’s native kinematic patterns and functional requirements could provide a basis towards subject-specific phenotyping. The goal of this study was to achieve a first step towards identifying easily accessible and intuitive features that allow for discrimination between implant designs based on kinematic data. A squat-cycle was simulated on eight fresh frozen specimens mounted in a weight-bearing knee rig, each initially tested under native conditions, and then after implantation with four different implant types (CR/CS, MS, LS, and PS). The kinematic signals of these five configurations were compared to determine whether key differences between implants could be detected leveraging two methodological approaches: (1) statistical parametric mapping to directly compare waveforms and (2) simple paired t-tests to compare the three-dimensional coordinates of the functional centres of rotation determined using a previously published REference FRame Alignment Method (REFRAME). While statistical parametric mapping of the kinematic data revealed only small differences in certain comparisons (e.g. LS vs. PS, and MS vs. LS) under lenient statistical testing conditions, the application of REFRAME showed clear differences between implants (for all implant combinations except for CR/CS vs. LS), even under conservative statistical testing. Since for most implant combinations, significant differences in the centres of rotation were found using REFRAME, this approach could present a suitable tool for discriminating between the kinematics of different implant types. Preoperative assessment of joint kinematics, combined with this REFRAME application, could therefore provide a key approach for improved clinical selection of implant type.

PMID:39755774 | DOI:10.1038/s41598-024-84522-w

Sci Rep. 2025 Jan 4;15(1):820. doi: 10.1038/s41598-024-84422-z.

ABSTRACT

Cervical cancer remains a major global health concern, with a specially alarming incidence in younger women. Traditional detection techniques such as the Pap smear and colposcopy often lack sensitivity and specificity and are highly dependent on the experience of the gynaecologist. In response, this study proposes the use of Hyperspectral Imaging, a pioneering technology that combines traditional imaging with spectroscopy to provide detailed spatial and spectral information. Over a period of six-months, our custom-designed hyperspectral colposcope was used on 62 patients. The gathered data underwent a specialized preprocessing workflow using a PCA-based strategy for unsupervised segmentation of the cervical region. This process extracted spectral signatures from various tissue types, and our subsequent statistical analysis highlighted its ability to detect differences and alterations in the cervical tissue. This offers a promising avenue for improving the precision of cervical lesion diagnosis.

PMID:39755771 | DOI:10.1038/s41598-024-84422-z

CJEM. 2025 Jan 4. doi: 10.1007/s43678-024-00843-9. Online ahead of print.

ABSTRACT

OBJECTIVES: Fundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians’ practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments.

METHODS: A cross-sectional survey was distributed to approximately 1000 emergency physician members of the Canadian Association of Emergency Physicians between March 4 and April 10, 2024. The survey, developed with ophthalmology and emergency medicine experts, included Likert scales and multiple-choice questions addressing confidence, practices, training, and experience with various fundoscopy modalities. Demographic data and responses were analyzed using descriptive statistics. Surveys were anonymous and available in English and French.

RESULTS: Seventy-four emergency physicians participated (mean experience 17.8 years), representing all Canadian provinces and territories. Most reported experience with traditional direct ophthalmoscopes (97.3%), slit lamp fundoscopy (82.2%) and panoptic ophthalmoscopes (58.9%). Only 1.4% had used binocular indirect ophthalmoscopes. No participant had experience with fundus cameras. Confidence in identifying fundus findings was low across all modalities, with only 13.7% reporting confidence using traditional ophthalmoscopes. Fundoscopy was performed frequently or always by 57.5% of the respondents, yet only 6.8% routinely used pupil dilation. Only 35.6% of the respondents felt their training in fundoscopy was adequate.

CONCLUSION: Emergency physicians in Canada report low confidence in fundoscopy despite its critical role in identifying vision- or life-threatening conditions. Traditional modalities are widely used but remain challenging for non-ophthalmologists. Fundus cameras, which offer ease of use and higher diagnostic accuracy, are underutilized.

PMID:39755766 | DOI:10.1007/s43678-024-00843-9

Sci Rep. 2025 Jan 4;15(1):840. doi: 10.1038/s41598-024-84565-z.

ABSTRACT

While recent studies have indicated a potential link between incense burning and respiratory diseases, there is a lack of data specifically focused on diabetic patients. To explore the relationship between indoor incense burning and impaired lung function among Chinese individuals with diabetes, a comprehensive cross-sectional study was undertaken, enrolling 431 adults diagnosed with diabetes. Information on incense burning and characteristics was collected using a structured questionnaire. The outcome of the study, impaired lung function, was assessed using spirometry. Multivariable logistic regression models were employed. In the fully adjusted model, participants exposed to indoor incense burning exhibited 130% higher odds of impaired lung function compared to those not exposed, as indicated by an odds ratio (OR) of 2.3 (95% confidence interval [CI]: 0.97, 5.16; P = 0.05). Notably, this association was statistically significant only in men (OR = 3.39; 95%CI: 1.07, 9.82; P = 0.03). Our study has elucidated an association between exposure to indoor incense burning and impaired lung function in individuals with diabetes, independently of demographic factors. These findings underscore the importance of considering indoor environmental factors, such as incense burning, in the comprehensive management and care of diabetic individuals.

PMID:39755765 | DOI:10.1038/s41598-024-84565-z

Sci Rep. 2025 Jan 4;15(1):844. doi: 10.1038/s41598-024-85010-x.

ABSTRACT

China has implemented the “tiered medical services” policy since 2015, while there is a paucity of data evaluating the the current status of chronic obstructive pulmonary disease (COPD) management under the system. Characteristics and treatments from 11,905 COPD patients in 88 hospitals across different tiers in China were included and analyzed. We assessed the statistical significance of differences by one way analysis of variance (ANOVA) for continuous variables and with the chi-squared test for categorical variables. Patients in primary hospitals (Tier1) exhibited heightened exposure to risk factors including smoking, household biofuel, and family history of respiratory diseases, and displayed elevated COPD assessment test (CAT) and modified Medical Research Council (mMRC) dyspnea scale scores, and worse lung function, in comparison to tertiary (Tier3) hospitals (P < 0.001). However, the utilization of inhaled maintenance treatments in Tier1 hospitals is markedly lower than that in Tier3 hospitals (54.8% vs. 81.3%, P < 0.001). At odds with the patients with more severer symptoms (as indicated by CAT ≥ 10 or mMRC ≥ 2), a higher proportion relied exclusively on single bronchodilators in Tier1 hospitals was observed compared to secondary (Tier2) and Tier3 hospitals (37.7% vs. 32.1% vs. 26.3%, 40.0% vs. 29.8% vs. 25.6%, P<0.001). Dual bronchodilators (long-acting β2-agonists /long-acting muscarinic antagonist, LABA/LAMA) represented the least common medication regimen across all tiers of hospitals, albeit their usage rates increased in tandem with hospital tier (0.7% vs. 7.2% vs. 10.4%, P < 0.001). In addition, the use of inhalation therapies containing inhaled corticosteroids (ICS) in China’s primary care is notably lower (16.9%) than the United States, the United Kingdom, and other middle-to-high-income countries (29.5-57.0%). There was compelling evidence pointing to greater disease severity in Tier1 hospitals, attributable to the lower and inappropriate utilization of inhaled maintenance treatments. This underscores the necessity for enhanced availability of medications and educational initiatives aimed at both physicians and patients within Tier1 hospitals.

PMID:39755745 | DOI:10.1038/s41598-024-85010-x

Sci Rep. 2025 Jan 4;15(1):761. doi: 10.1038/s41598-024-81271-8.

ABSTRACT

Active transportation, such as cycling, improves mobility and general health. However, statistics reveal that in low- and middle-income countries, male and female cycling participation rates differ significantly. Existing literature highlights that women’s willingness to use bicycles is significantly influenced by their perception of security. This study employs virtual reality (VR) cycling simulation and electroencephalography (EEG) analysis to investigate factors influencing female cyclists’ perceptions of security in Tehran. A total of 52 female participants took part in four scenarios within a VR bicycle simulator, which simulates various environmental settings. In this experiment, participants’ brainwave signals are gathered through an EEG device, and a questionnaire with their stated preferences is filled out. The Gaussian mixture approach is used to cluster brainwave patterns based on security perception from EEG data. Subsequently, four supervised machine learning methods, random forest, support vector machine, logistic regression, and multilayer perceptron, are utilized to classify influential factors on security perception using clustered EEG data. Consequently, the support vector machine model, with an F1 score of 0.74, appears to be the most effective technique for the classification of environmental and surveillance factors. Furthermore, the SelectKBest algorithm determines that factors such as the presence of obstacles like kiosks, cycling routes passing through tunnels and underpasses, the level of incivility in the urban cycling environment, and the presence of informal surveillance have the biggest impact on female cyclists’ security perception.

PMID:39755730 | DOI:10.1038/s41598-024-81271-8

Sci Rep. 2025 Jan 4;15(1):802. doi: 10.1038/s41598-024-79424-w.

ABSTRACT

Children are highly sensitive to toxins which can damage their organs and lead to death. Investigating the main causes of intoxication could reduce mortality and morbidity in children. In this cross-sectional study, the documents of all poisoned patients (214 cases) admitted to the emergency department of Taleghani children`s Hospital between April 2020 and 2023 were investigated. Approximately 51% of them were females. There were 87 cases (45.3%) of illicit drug poisoning, which included methadone 43.8%, opium 41.4%, amphetamine 8.2%, cannabis 3.3%, buprenorphine 2.2%, and tramadol 1.1%. Children who were poisoned by illicit drugs presented with impaired level of consciousness (92.5%), unstable vital signs and abnormal laboratory results. The level of serum glucose was higher in methadone toxicity. Three and two cases, due to methadone and opium poisoning died. Children with illicit drugs poisoning in terms of vital signs and laboratory data were worse compared to other poisonings and mortality is high in this group. In this study, the blood sugar in methadone poisoning cases was statistically significantly different from other drugs, and it is suggested that in cases of children suspected of poisoning with illicit drugs and high blood sugar, methadone poisoning should be considered in the differential diagnosis.

PMID:39755707 | DOI:10.1038/s41598-024-79424-w