Nevin Manimala

J Head Trauma Rehabil. 2025 Feb 7. doi: 10.1097/HTR.0000000000001016. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the relationship between neighborhood disadvantage and severity of vestibular, sensory, mood-behavioral, and cognitive neurobehavioral symptoms among Veterans with a mild traumatic brain injury (mTBI); and whether Veterans in underrepresented racial/ethnic groups with high neighborhood disadvantage experience the most severe symptoms.

SETTING: Outpatient Veterans Health Administration (VHA).

PARTICIPANTS: Veterans with the following data available in the electronic health record (2014-2020): (1) clinician-confirmed mTBI and complete neurobehavioral symptom inventory (NSI) as part of their comprehensive traumatic brain injury evaluation (CTBIE) and (2) area deprivation index (ADI) scores assessing neighborhood disadvantage from the same quarter as their CTBIE.

DESIGN: Retrospective cohort study. Latent variable regression was used to examine unique and interactive relationships between neighborhood disadvantage, race/ethnicity, and neurobehavioral symptoms.

MAIN MEASURES: NSI and ADI national percentile rank.

RESULTS: The study included 58 698 eligible Veterans. Relative to Veterans in the first quintile of ADI national percentile rank, representing those with the least neighborhood disadvantage, Veterans in the ADI quintiles indicating greater neighborhood disadvantage reported more severe vestibular, sensory, mood-behavioral, and cognitive symptoms. The strongest associations between neighborhood disadvantage and neurobehavioral symptoms were observed within the sensory (β = 0.07-0.16) and mood-behavioral domains (β = 0.06-0.15). Statistical interactions indicated that the association between underrepresented racial/ethnic group status (vs. identifying as white, non-Hispanic) and the severity of neurobehavioral symptoms did not differ among those with severe neighborhood disadvantage versus those without.

CONCLUSION: Veterans with mTBI living in more disadvantaged neighborhoods reported more severe neurobehavioral symptoms relative to those in the most advantaged neighborhoods, with the strongest relationships detected within the sensory and mood-behavioral domains. While neighborhood disadvantage and underrepresented race/ethnicity were both independently associated with symptoms, these factors did not interact to produce more severe symptoms. Findings suggest that addressing factors driving socioeconomic disadvantage may assist in mitigating symptoms in this population.

PMID:39919249 | DOI:10.1097/HTR.0000000000001016

Environ Toxicol Chem. 2025 Feb 1;44(2):484-496. doi: 10.1093/etojnl/vgae039.

ABSTRACT

The pH of freshwater ecosystems affects bioavailability of various metals to various organisms, including daphnids. Although it is well known that daphnid species show interclonal variation of metal sensitivity, knowledge about interclonal variation of bioavailability effects, such as the pH effect, is scarce. Here, we compared the effect of pH on chronic copper toxicity between two clones of Ceriodaphnia dubia, within its natural pH niche, which we determined to be approximately pH 6.5-8.5 based on existing experimental and biological monitoring data. Using a Bayesian modeling approach, we found that the effect of pH was not statistically significantly different between the two clones (with a credibility > 95%). Overall, we found an approximately threefold decrease in chronic Cu toxicity with increasing pH between pH 6.5 and 8.5, with 7-day 20% effect concentration (EC20) values ranging between 11.0 and 30.9 µg/L dissolved Cu. We then calibrated a preliminary generalized bioavailability model (gBAM) using these data and found a pH-effect slope parameter SpH = -0.247, which is within the range of previously reported values for Daphnia magna (-0.056 to -0.361) and similar to the SpH value of -0.220 used in the “invertebrate gBAM” for bioavailability-based Cu risk assessment under the Registration, Evaluation, Authorisation and Restriction of Chemicals. The preliminary C. dubia gBAM captured the magnitude of the observed pH effect well (mean of 1.3-fold EC20 prediction error, n = 9). It was also able to accurately predict chronic Cu toxicity in natural waters reported in an independent dataset (mean of 1.4-fold prediction error, n = 6). Also, two D. magna gBAMs (for two clones) and the invertebrate gBAM showed comparable predictive capabilities. Collectively, our work highlights the importance of studying relations between pH and metal bioavailability within the species’ natural niche. It also confirms earlier findings that biological variation of pH-bioavailability relations typically does not have a large impact on predictive capacity of bioavailability models, which is important for regulatory applications.

PMID:39919235 | DOI:10.1093/etojnl/vgae039

Prim Care Companion CNS Disord. 2025 Jan 28;27(1):24m03723. doi: 10.4088/PCC.24m03723.

ABSTRACT

Introduction: Mental health of health care workers (HCWs) was affected during the COVID-19 pandemic due to direct handling of suspected and confirmed cases. While neurobiological mechanisms that mediate stress, depression, and anxiety are well established, psychological mechanisms are not.

Objective: To assess (1) the prevalence of anxiety, depression, insomnia, and perceived stress among accredited social health activists, multipurpose health workers, auxiliary nurse midwives, and other certified HCWs of rural areas of Telangana, India and (2) the factors that mediate stress with depression and anxiety.

Methods: A total of 300 HCWs from across 10 primary health centers across 5 districts were selected. All participants self-reported their anxiety, depression, sleep problems, and perceived stress related to the pandemic. Sociodemographic and other relevant data pertinent to the context of stress and the pandemic were also obtained. The survey used translated and validated self report instruments and was conducted during August and September 2021.

Results: The mean (SD) scores on the Insomnia Severity Index, 7-item Generalized Anxiety Disorder scale, Pandemic-Related Perceived Stress Scale of COVID-19, and 9-item Patient Health Questionnaire were 5.94 (5.6), 4.21 (4.5), 21.94 (5.8), and 3.89 (4.8), respectively. Age <35 years and family members being COVID-19 positive were significant predictors of depression and anxiety, respectively. Greater number of family members and COVID-19-positive status were significant predictors of insomnia. While the effect of stress on anxiety was indirect through the mediation of insomnia and depression, the effect of stress on depression was direct as well as through the mediation of anxiety.

Conclusion: The study results highlight the importance of measures to address sleep-related issues in individuals who are experiencing psychosocial stressors to prevent the development of depression and anxiety.

Prim Care Companion CNS Disord 2025;27(1):24m03723.

Author affiliations are listed at the end of this article.

PMID:39919227 | DOI:10.4088/PCC.24m03723

Nurs Res. 2025 Feb 6. doi: 10.1097/NNR.0000000000000810. Online ahead of print.

ABSTRACT

BACKGROUND: The analysis of health diary data has long relied on inferential statistical methods focusing on sample means and ad hoc methods to calculate each individual’s variation in health outcomes.

OBJECTIVES: In this paper, an advanced statistical model is applied to daily diary self-reported health outcomes to simultaneously study an individual’s likeliness to report an outcome, daily mean intensity level, and variability in daily measures.

METHODS: Using observational, secondary data from 782 adults, we analyzed self-report daily fatigue symptoms, distinguishing between whether an individual reported fatigue and its severity when reported. Self-reported depressed affect and participant characteristics were used as predictors of daily fatigue symptoms.

RESULTS: A higher likeliness to report fatigue correlated with higher mean fatigue severity and greater stability in severity ratings. Higher mean severity correlated with greater stability in severity ratings. Females and those with high depressed affect were more likely to report fatigue. Females and those with high depressed affect reported greater mean severity.

DISCUSSION: The model applied to daily measures allowed for the simultaneous study of an individual’s likeliness to report a symptom, daily mean symptom severity, and variability in severity across days. An individual’s daily variation in symptom severity was represented as a model parameter that did not contain measurement error that is present in ad hoc methods.

PMID:39919218 | DOI:10.1097/NNR.0000000000000810

J Craniofac Surg. 2025 Feb 7. doi: 10.1097/SCS.0000000000011127. Online ahead of print.

ABSTRACT

INTRODUCTION: Alveolar cleft grafting plays a vital role in the treatment of individuals with cleft lip and palate. Vitamin D plays a crucial role in bone healing.

METHODOLOGY: The study involved 40 patients with cleft alveolus who were seeking alveolar cleft grafting (ACG). Participants were categorized into 2 groups-study and control-based on their vitamin D levels: those with levels below 20 were placed in the control group, while those with levels above 20 were assigned to the study group.

RESULTS: Assessment of alveolar cleft grafting success rate was done by Bergland Scale assessment. The assessment using χ2 showed that the bone level in the study group was better than the control. However, the improvement was not statistically significant (P=0.2). Assessment of volumetric bone fill was done on the CBCT. The results were statistically checked by independent t-test and showed that the bone fill in the study group (224±78.4 mm3) was better than the control (176±135 mm3). However, the improvement was not statistically significant (P=0.17). Assessment of the incidence of fistula recurrence was done using the χ2 test. In the study group, the incidence of fistula was 5%, while in the control group, it was 30%. The incidence of success in reducing fistula recurrence was statistically significant (P=0.04).

CONCLUSION: Adjustment of vitamin D level may be a successful tool in predicting the success of the alveolar cleft grafting procedure, especially regarding the elimination of fistula recurrence.

PMID:39919215 | DOI:10.1097/SCS.0000000000011127

Prehosp Emerg Care. 2025 Feb 7:1-16. doi: 10.1080/10903127.2025.2462774. Online ahead of print.

ABSTRACT

OBJECTIVES: Personal attitudes amongst emergency medical services (EMS) clinicians could influence successful implementation of prehospital buprenorphine administration programs (PBAPs), yet few studies have investigated EMS clinician perceptions concerning these innovative programs. This mixed-methods study assessed EMS clinician perceptions and concerns about PBAPs.

METHODS: Emergency Medical Technicians (EMTs), advanced EMTs and paramedics were recruited for focus groups from Upstate South Carolina. Researchers moderated groups of 12 or fewer and field personnel were interviewed separately from EMS training officers and leadership. Participants took a survey assessing demographic, employment, and contextual information on EMS-led interventions addressing the opioid epidemic. Moderators asked participants to provide confidential responses to four open-ended questions. Thematic analysis was applied to all responses using the framework method. A codebook was modeled using deductive themes from previous literature, while inductive themes and subthemes were added through researcher consensus. Final coding of themes and subthemes was constructed independently by two researchers with disagreements resolved by a third. Descriptive statistics summarized demographic, employment, and contextual information collected from the survey.

RESULTS: The 107 participants were predominantly male (69.2%) and White (96.3%) with an average age of 38.4 years (SD = 11.4). Half were paramedics and 35.5% were EMTs with EMS experience ranging from 3 months to 39 years, median of 10 years. Most (70.2%) heard of buprenorphine and 28.9% received education on medication for opioid use disorder (MOUD). Describing initial reactions to an overdose, themes included overdoses as a routine part of EMS and naloxone distribution changing overdose dynamics. Themes included opioid withdrawal is not a medical emergency, buprenorphine negatively affecting EMS operations, and PBAPs requiring culture shift. Themes surrounding concerns included EMS clinician perceptions of individuals with opioid use disorder (OUD), PBAPs increasing substance misuse, and buprenorphine increasing EMS clinician liability. At the end of the session 45.8% stated they would want their EMS agency to participate in a PBAP, 44.9% would not want their agency to participate, and 8 (7.5%) did not answer.

CONCLUSIONS: Emergency medical services clinicians’ perceptions towards prehospital buprenorphine administration could influence adoption of PBAP protocols. Findings may inform PBAP educational initiatives which mitigate these concerns and knowledge gaps.

PMID:39919214 | DOI:10.1080/10903127.2025.2462774

Prehosp Emerg Care. 2025 Feb 7:1-9. doi: 10.1080/10903127.2025.2462211. Online ahead of print.

ABSTRACT

OBJECTIVES: Emergency medical services (EMS) post-overdose outreach programs expand beyond traditional 9-1-1 response to offer overdose survivors linkage to substance use treatment and other related harm-reducing interventions. Although intuitive and increasingly popular, evidence to define expected outcomes is exceedingly limited. We evaluated process and patient outcomes of one large Midwestern post-overdose outreach program to describe outreach characteristics and linkage to substance use treatment.

METHODS: This retrospective cohort study used clinical program records of individuals referred to a multidisciplinary post-overdose outreach program following a non-fatal presumed opioid overdose with emergency response. Measures included (i) number of outreach attempts, (ii) modalities of outreach attempts (in-person visit, text message, letter, phone call, or electronic mail), (iii) outcome of outreach (i.e., if the individual was contacted), (iv) interventions provided including linkage to substance use treatment with coordinated admission and transportation. We used descriptive statistics to report patient characteristics, outreach frequency, outreach modality, successful contact, and treatment linkage through the program.

RESULTS: From 2020-2022, the program attempted outreach to 3,437 individuals. The median age was 37 years (interquartile range, IQR, 30-47). Most individuals were white/non-Hispanic (n = 2,077, 63.1%) and male (n = 2,084, 61.2%). Few were unhoused at the time of outreach (n = 246, 7.2%). The program made a total of 7,935 outreach attempts with a median of 2 outreach attempts (IQR 1-3) per individual. The most common outreach modalities were in-person visit (n = 3,300, 41.6%) and text message (n = 2,776, 35.0%), though phone calls and in-person visits most often resulted in successful contact (52.6% and 23.7%, respectively). Outreach attempts resulted in 743 (21.6%) successful contacts and the program linked 304 individuals (40.9% of all contacted individuals, 8.8% of all attempted outreach) to treatment. Notably, 160 (52.6%) of the 304 individuals linked to treatment required 3 or more outreach attempts before treatment linkage occurred.

CONCLUSIONS: Post-overdose outreach initiated by EMS can successfully find and link individuals to substance use treatment following a non-fatal opioid overdose. However, this intervention may be resource intensive, often requiring multiple attempts at outreach and several modalities of interaction to facilitate treatment linkage.

PMID:39919200 | DOI:10.1080/10903127.2025.2462211

Mol Pharmacol. 2025 Jan;107(1):100010. doi: 10.1016/j.molpha.2024.100010. Epub 2024 Dec 12.

ABSTRACT

Chemokine receptors CCR3, CCR4, and CCR5 are G protein-coupled receptors implicated in diseases like cancer, Alzheimer’s, asthma, human immunodeficiency virus (HIV), and macular degeneration. Recently, CCR3 and CCR4 have emerged as potential stroke targets. Although only the CCR5 antagonist maraviroc is US Food and Drug Administration-approved (for HIV), we curated data on CCR3, CCR4, and CCR5 antagonists from ChEMBL to develop and validate machine learning models. The top 5-fold cross-validation statistics for these models were high for both classification and regression models for CCR3 (receiver operating characteristic [ROC], 0.94; R² = 0.8), CCR4 (ROC, 0.98; R² = 0.57), and CCR5 (ROC, 0.96; R² = 0.78). The models for CCR3/4 were used to screen a small library of US Food and Drug Administration-approved drugs and 17 were initially tested in vitro against both CCR3/4 receptors. A promising compound lapatinib, a dual tyrosine kinase inhibitor, was identified as an antagonist for CCR3 (IC₅₀, 0.7 μM) and CCR4 (IC₅₀, 1.8 μM). Additional testing also identified it as an CCR5 antagonist (IC₅₀, 0.9 μM), and it showed moderate in vitro HIV I inhibition. We demonstrated how machine learning can be used to identify molecules for repurposing as antagonists for G protein-coupled receptors such as CCR3, CCR4, and CCR5. Lapatinib may represent a new orally available chemical probe for these 3 receptors, and it provides a starting point for further chemical optimization for multiple diseases impacting human health. SIGNIFICANCE STATEMENT: We describe the building of machine learning models for the chemokine receptors CCR3, CCR4, and CCR5 trained on data from the ChEMBL database. Using these models, we identified lapatinib as a potent inhibitor of CCR3, CCR4, and CCR5. Our study illustrates the potential of machine learning in identifying molecules for repurposing as antagonists for G protein-coupled receptors, including CCR3, CCR4, and CCR5, which have various therapeutic applications.

PMID:39919162 | DOI:10.1016/j.molpha.2024.100010

PLoS One. 2025 Feb 7;20(2):e0317889. doi: 10.1371/journal.pone.0317889. eCollection 2025.

ABSTRACT

Soil erosion is a pervasive global challenge and a significant ecological and environmental concern in China. Its occurrence frequently triggers ecological crises, including soil degradation and water contamination. It is of great scientific and practical significance to study the factors influencing the mechanism of soil erosion occurrence. Economic development in the Dabie Mountains of China has necessitated the conversion of vast tracts of forest land into economic crops, notably tea gardens and orchards, thereby disrupting soil structure and precipitating large-scale soil erosion. Rainfall serves as the primary catalyst for soil erosion in this region. Therefore, this study was designed to reveal the evolution characteristics of rainfall-induced slope erosion and the key influencing factors in the forest land converted to cash crop area in Dabie Mountains. It focused on a tea plantation slope of the Dabie Mountains, employing four rainfall scenarios, i.e. light rain, moderate rain, heavy rain, and heavy rain following drought, to conduct in-situ simulation experiments, mirroring the prevalent rainfall patterns in the study region. Monitoring stations for soil moisture content, slope runoff, and soil erosion were strategically positioned at varying depths across experimental plots with vegetation cover percentages of 20%, 40%, and 60%. Mathematical methods of descriptive statistics were used to analyze the monitored runoff, soil erosion and soil water content data, and to study the characteristics of their changes and response relationships. The findings underscore that rainfall prompts a swift surge in surface soil moisture, destabilizing the soil surface and culminating in slope erosion; thus, the rate of change in surface soil moisture content emerges as a pivotal indicator for predicting slope soil erosion. Furthermore, within the bounds of rainfall infiltration, preceding drought conditions followed by intense rainfall exacerbate soil erosion accumulation, highlighting the significance of initial soil moisture content as a critical factor. Lastly, for the economic crop cultivation zones in the Dabie Mountains, achieving a vegetation cover of 40% or more can significantly enhance soil water retention capacity and the overall soil and water conservation efficacy.

PMID:39919158 | DOI:10.1371/journal.pone.0317889

PLoS One. 2025 Feb 7;20(2):e0317715. doi: 10.1371/journal.pone.0317715. eCollection 2025.

ABSTRACT

BACKGROUND: Under-5 mortality remains a critical social indicator of a country’s development and economic sustainability, particularly in developing nations like Bangladesh. This study employs machine learning models, including Linear Regression, Ridge Regression, Lasso Regression, Bayesian Ridge, Decision Tree, Gradient Boosting, XGBoost, and CatBoost, to forecast future trends in under-5 mortality. By leveraging these models, the study aims to provide actionable insights for policymakers and health professionals to address persistent challenges.

METHODS: Data from the 1993-94 to 2017-18 Bangladesh Demographic and Health Survey (BDHS) was analyzed using advanced machine learning algorithms. Key metrics, including Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), R-squared, and Mean Absolute Percentage Error (MAPE), were employed to evaluate model performance. Additionally, k-fold cross-validation was conducted to ensure robust model evaluation.

RESULTS: This study confirms a significant decline in under-5 mortality in Bangladesh over the study period, with machine learning models providing accurate predictions of future trends. Among the models, Linear Regression emerged as the most accurate, achieving the lowest MAE (4.05), RMSE (4.56), and MAPE (6.64%), along with the highest R-squared value (0.98). Projections indicate further reductions in under-5 mortality to 29.87 per 1,000 live births by 2030 and 26.21 by 2035.

CONCLUSIONS: From 1994 to 2018, under-5 mortality in Bangladesh decreased by 76.72%. While the Linear Regression model demonstrated exceptional accuracy in forecasting trends, long-term predictions should be interpreted cautiously due to inherent uncertainties in socio-economic conditions. The forecasted rates fall short of the Sustainable Development Goal (SDG) target of 25 deaths per 1,000 live births by 2030, underscoring the need for intensified interventions in healthcare access and maternal health to achieve this target.

PMID:39919148 | DOI:10.1371/journal.pone.0317715