Nevin Manimala

Int J Ment Health Syst. 2026 Jun 21. doi: 10.1186/s13033-026-00716-x. Online ahead of print.

ABSTRACT

This article examines the relationship between behavioral and Environmental, Social, and Governance (ESG) variables and the Mental Health Index (MHI) of Italian regions from 2016 to 2023. The use of descriptive statistics, cluster analysis, and forecasting models is employed for descriptive and exploratory purposes, as well as for forecasting regional disparities in mental health. Relative stability at the state level and persistent territorial variability are evident in the MHI derived from the ISTAT-BES indicators, with the North and Centre performing better than the South, except for notable improvements in disadvantaged regions such as Calabria and Campania. Behavioral factors, particularly sedentariness, smoking, and multimorbidity, are consistently associated with adverse trends for mental health, while adequate nourishment and exposure to urban green spaces are found to be protective. ESG-related factors, including occupational security and judicial efficacy, also contribute to these inequalities, attributing mental health status as part of the more general system effects of institutions and environments. Cluster analysis identifies distinct regional typologies based on aggregated behavioral and ESG patterns, while the predictive model highlights multimorbidity, smoking, and sedentary behavior as the most relevant factors negatively associated with the Mental Health Index (MHI), and urban green availability as a key factor positively associated with it. They point out that Italian mental health disparities are not only associated with behavioral determinants of individuals, but must be addressed from a multi-faceted ESG perspective. Policy reactions also mean that public health responses must attend not only to lifestyle risk factors but also structural determinants and incorporate active living promotion, reduction of smoking prevalence, investment in green infrastructures, and improvement of governance efficiency.

PMID:42324584 | DOI:10.1186/s13033-026-00716-x

BMC Sports Sci Med Rehabil. 2026 Jun 22. doi: 10.1186/s13102-026-01818-2. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged sedentary work is associated with hamstring tightness, reduced flexibility, and functional limitations among information technology (IT) professionals. Comparative evidence for static stretching and myofascial release (MFR) in this population remains limited.

OBJECTIVE: To compare the short-term effects of static stretching and myofascial release on hamstring tightness and lower extremity function in sedentary IT professionals.

METHODS: In this two-arm randomized controlled trial, 30 IT professionals were allocated to static stretching (n = 15) or MFR (n = 15). Both groups received stipulated treatment five times weekly for three weeks. Active knee extension range of motion (AKE-ROM) was the primary outcome measure, and the self-reported Lower Extremity Functional Scale (LEFS) was the secondary outcome measure. Outcomes assessments were performed at baseline and days 8, 15, and 22. Data were analyzed using linear mixed-effects models examining group, time, and group-by-time interaction effects, with Bonferroni-adjusted post hoc comparisons.

RESULTS: Both interventions significantly improved AKE-ROM and self-reported LEFS over time (all p < 0.001). A significant group-by-time interaction favored static stretching for AKE-ROM, with greater adjusted improvements at Day 15 (mean difference 3.27°, 95% CI 2.28-4.26) and Day 22 (5.20°, 95% CI 4.21-6.19; both p < 0.001). Although these between-group differences were statistically significant, the Day 22 difference remained smaller than previously reported minimal detectable change values for the AKE test. Self-reported LEFS scores improved significantly in both groups, with between-group differences remaining small and below clinically meaningful thresholds, indicating broadly comparable functional benefit. Sensitivity analyses adjusting for age and BMI yielded consistent findings. No adverse events were reported.

CONCLUSIONS: Both interventions improved AKE-ROM and self-reported LEFS over the study period. Static stretching demonstrated statistically greater improvements in AKE-ROM; however, the magnitude of this difference was smaller than published minimal detectable change values, and its clinical importance remains uncertain. Given the absence of a control group and the short follow-up period, findings should be interpreted cautiously.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06586554; initial release date: 04/09/2024.

PMID:42324573 | DOI:10.1186/s13102-026-01818-2

BMC Psychol. 2026 Jun 22. doi: 10.1186/s40359-026-04918-3. Online ahead of print.

ABSTRACT

BACKGROUND: As educational priorities increasingly emphasize higher-order cognitive skills over rote memorization, it has become essential to clarify how these competencies interact in young learners. To address this, the current study examines how primary school students’ problem-solving and decision-making skills mediate the relationship between their critical thinking dispositions and self-perceptions of success.

METHOD: The sample consisted of 285 third- and fourth-grade students in Türkiye, aged 8 to 10 years, who were selected based on their enrollment status, absence of psychiatric diagnoses, and voluntary participation. Data were collected in person using paper-based surveys. Four instruments were administered: the Critical Thinking Dispositions Scale, the Problem-Solving Inventory for Children, the Decision-Making Skills Scale, and the Perception of Success Scale. Direct and indirect relationships between variables were assessed using path analysis. Bootstrapping procedures determined the statistical significance of the mediating effects.

RESULTS: The indirect effects of decision-making and problem-solving skills on the relationship between critical thinking disposition and perception of success were statistically significant [β = .20, SE = .05 (95% CI = .095, .308)]. The results indicate that students with advanced critical thinking, problem-solving, and decision-making skills are more likely to perceive themselves as academically successful.

CONCLUSION: The study confirms that critical thinking, problem-solving, and decision-making are interconnected competencies that significantly predict students’ perceptions of success. These results support educational initiatives that prioritize higher-order cognitive abilities over basic knowledge retention. Ultimately, educators are encouraged to implement comprehensive curricula that simultaneously develop these skills to prepare students for real-world challenges.

PMID:42324563 | DOI:10.1186/s40359-026-04918-3

J Cardiothorac Surg. 2026 Jun 21. doi: 10.1186/s13019-026-04478-y. Online ahead of print.

ABSTRACT

OBJECTIVES: Lung cancer is a leading cause of cancer-related death globally, with non-small cell lung cancer (NSCLC) being the predominant form. Genetic factors significantly influence individual susceptibility. This study investigated the association of TP63 (rs7631358) and CIR1 (rs13009079) polymorphisms with NSCLC risk in a Chinese population.

METHODS: A case-control study was conducted with 500 NSCLC patients and 500 matched controls. Genotyping was performed using the SEQUENOM MassARRAY platform. Associations were evaluated using chi-square tests and logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: In the pre-specified primary analysis with FDR correction, both TP63 rs7631358 (A/G + A/A vs. G/G: adjusted OR = 1.409, FDR P = 0.030) and CIR1 rs13009079 (T/T vs. C/T + C/C: adjusted OR = 1.390, FDR P = 0.030) were significantly associated with an increased risk of lung adenocarcinoma after adjustment for smoking status, gender, and age. Exploratory subgroup analyses suggested that the TP63 association was more pronounced among ever-smokers, although the gene-smoking interaction did not reach statistical significance.

CONCLUSIONS: TP63 rs7631358 and CIR1 rs13009079 polymorphisms are significantly associated with the susceptibility to lung adenocarcinoma in the Chinese Han population after correction for multiple testing. These findings support a role for the TP63-mediated DNA damage response pathway and the CIR1-Notch signaling pathway in ADC pathogenesis. Replication in larger, independent cohorts is warranted to confirm these associations and to further evaluate their potential for clinical risk stratification.

PMID:42324549 | DOI:10.1186/s13019-026-04478-y

Diabetol Metab Syndr. 2026 Jun 21. doi: 10.1186/s13098-026-02215-y. Online ahead of print.

ABSTRACT

BACKGROUND: Sugar-sweetened beverages (SSBs) consumption has become an emerging global public health concern. The relationship between SSBs consumption and mortality is not yet fully clarified. This study aims to quantify the dose-response relationships between SSBs consumption and mortality risks in US and UK cohorts, while also reviewing up-to-date estimates of SSB-related burden from 1990 to 2021 at a national level.

METHODS: We conducted a nationwide prospective cohort study and systematic analysis. The study included 13,438 participants from US National Health and Nutrition Examination Survey (NHANES) (1999-2000 and 2017-2018), and 63,436 participants from UK Biobank (2006-2010). For the systematic analysis using Global Burden of Disease (GBD) 2021 data, mortality and disability-adjusted life years (DALYs) for the US and UK (1990-2021) were analyzed to generate estimates.

RESULTS: In the US population, during a 9.17-year cohort follow-up, 1,929 deaths were identified among 13,438 participants, while in the UK population, during a 12.41-year cohort follow-up, 3,466 deaths were identified among 63,436 participants. A significant dose-response association was found between higher SSBs consumption and increased all-cause mortality (both P for trend < 0.001), as well as mortality due to cardiovascular disease and chronic lower respiratory diseases. In GBD, SSBs-related mortality and DALYs rates were higher in older populations (55 + years) in both countries, consistent with the results in US NHANES and UK Biobank. Ischemic heart disease and type 2 diabetes mellitus were leading contributors to these burdens.

CONCLUSIONS: This study establishes a robust relationship between SSBs consumption and all-cause mortality, mortality caused by cardiovascular disease and chronic lower respiratory diseases. In line with GBD findings, SSBs consumption, especially among elderly populations, should be considered a crucial public health concern.

PMID:42324544 | DOI:10.1186/s13098-026-02215-y

BMC Oral Health. 2026 Jun 22. doi: 10.1186/s12903-026-08935-x. Online ahead of print.

ABSTRACT

BACKGROUND: Tongue function significantly influences craniofacial development, yet the morpho-functional characteristics of the tongue across different sagittal skeletal patterns remain unclear. This study aimed to quantitatively evaluate tongue muscle strength and resting posture in adolescents, delineate their biomechanical pathways, and construct data-driven diagnostic models for sagittal skeletal patterns.

METHODS: A cross-sectional study was conducted on 182 adolescents (11-17 years) stratified into Class I, II, and III sagittal patterns based on the ANB angle. Maximum active tongue pressure (MTP) was measured using a digital dynamometer. Resting posture, including the Tongue Tip Index (TTI), Tongue Tip Distance (TTD), and Tongue Dorsum Distance (TDD), was evaluated using lateral cephalograms. Data were analyzed using multivariable linear regression analysis, mediation analysis, and a Chi-squared Automatic Interaction Detection (CHAID) algorithm.

RESULTS: The Class III cohort exhibited significantly reduced MTP (median: 1.65 kg) compared to Class I and II subjects (~ 2.20 kg; P < 0.001). Mediation analysis identified a partial mediation relationship: while MTP demonstrated a significant direct statistical association with the ANB angle, 32.4% of the total association was indirectly mediated through TTI. The CHAID model identified reduced MTP (≤ 1.85 kg) as the primary root node associated with Class III risk. TTI (≤ 2.57%) served as a critical secondary stratifier of Class III risk.

CONCLUSIONS: In adolescents, skeletal Class III malocclusion is associated with reduced tongue pressure and a lowered resting posture. Tongue muscle force demonstrates both a direct statistical association with the sagittal skeletal base and an indirect association mediated by the maintenance of an appropriate tongue tip position. The diagnostic model highlights reduced MTP as the primary risk indicator for Class III patterns, which is further stratified by TTI.

PMID:42324535 | DOI:10.1186/s12903-026-08935-x

BMC Nurs. 2026 Jun 21. doi: 10.1186/s12912-026-04945-w. Online ahead of print.

ABSTRACT

BACKGROUND: Job satisfaction is a key determinant of nursing performance and retention, yet married female nurses may face unique personal and professional demands that influence their workplace experiences.

METHODS: This descriptive cross-sectional study assessed the level of job satisfaction and the personal, work-related, and socio-economic factors associated with job satisfaction among married female nurses working at a District General Hospital in the Southern Province of Sri Lanka. A sample of 306 nurses was selected through simple random sampling, and data were collected using a self-administered questionnaire comprising demographic variables and the validated Nurse Job Satisfaction Scale (ESET). Descriptive statistics and one-way ANOVA were performed using SPSS version 26, with statistical significance set at p < 0.05.

RESULTS: A total of 251 nurses responded. Overall job satisfaction was high (132.07 ± 20.64), with the highest satisfaction observed in professional recognition (3.9 ± 0.66) and the lowest in recognition and remuneration (3.00 ± 0.85). Significant associations were identified between job satisfaction and age (p = 0.031), workplace unit (p = 0.001), and educational level (p = 0.010).

CONCLUSIONS: These findings underscore the complexity of job satisfaction and highlight the need for further research to explore additional associated factors affecting married female nurses.

PMID:42324532 | DOI:10.1186/s12912-026-04945-w

BMC Vet Res. 2026 Jun 22. doi: 10.1186/s12917-026-05665-8. Online ahead of print.

ABSTRACT

BACKGROUND: Peste des Petits Ruminants (PPR) is a highly contagious transboundary viral disease affecting small ruminants, with significant socio-economic consequences in areas such as Borana Zone, Southern Ethiopia. This sero-monitoring study was conducted in Yabello, Taltale, and Elwaya districts of Borana zone to evaluate the Post-vaccination immunity status of local sheep and goats against PPR.

METHODS: Three stage sampling methods were used to select peasant associations (PA), villages and individual animals. A total of 901 sera samples were collected from 578 to 323 vaccinated goats and sheep, respectively. Competitive ELISA was employed as a tool of diagnosis.

RESULTS: An overall sero-conversion rate of 93.23% (95% CI: 91.40%-94.69%) was recorded. Statistically significant differences in sero-conversion were observed across age groups (higher in small ruminants > 2 years; P = 0.001; odds ratio = 3.35) and history of movement (higher in those having no history of migration; P = 0.04; odds ratio = 2.15). However, no significant differences were observed among species (P = 0.95; odds ratio = 1.02), sex groups (P = 0.16; odds ratio = 2), districts (P = 0.23; odds ratio = 1.66), and timing between vaccination and sampling for sero-monitoring (P = 0.06; odds ratio = 2.18).

CONCLUSIONS: The findings suggest the effectiveness of the vaccination program. The development of protective immunity in substantial proportion of goats and sheep after vaccination confirmed successful induction of flock immunity. Developing a strategy to track and manage the movement of small ruminants to minimize the introduction of unvaccinated animal is suggested.

PMID:42324530 | DOI:10.1186/s12917-026-05665-8

BMC Pediatr. 2026 Jun 22. doi: 10.1186/s12887-026-07208-4. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic-resistant bloodstream infections are a major public health concern, particularly in children under five years of age. The objective of this study was to determine the prevalence of bloodstream infections and assess the antimicrobial resistance profiles and their associated factors among febrile children under five years of age in Bahir Dar, northwest Ethiopia.

METHODS: A cross-sectional study was conducted from November to December 2025 among 281 children under five years of age who attended the pediatric clinic of Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar. Sociodemographic and clinical data were collected using a structured questionnaire through face-to-face interviews with the parents or guardians. Approximately 3 mL of venous blood was aseptically collected and cultured using standard microbiological techniques. Bacterial identification was performed based on colony characteristics and biochemical tests. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Data were entered into EpiData version 3.1 and analyzed using SPSS version 26. Logistic regression analysis was used to identify factors associated with bloodstream infections, and statistical significance was set at p < 0.05.

RESULTS: The prevalence of bloodstream infection was 19.2% (54/281; 95% CI: 14.0%-24.4%). The most common isolate was Klebsiella pneumoniae (31%), followed by Enterobacter cloacae (11%), Escherichia coli (9%), and Acinetobacter baumannii (9) %. Gram-negative bacteria accounted for 80% of the isolates. Antimicrobial susceptibility testing revealed high resistance rates to commonly used antibiotics, particularly ampicillin (87.0%, 40/46), trimethoprim-sulfamethoxazole (86.3%, 44/51), and cefepime 42/54 (77.8). Resistance was also high to ciprofloxacin (68.5%, 37/54), tobramycin (68.6%, 35/51), amoxicillin-clavulanic acid (66.0%, 31/47), gentamicin (63.3%, 31/49), tetracycline (61.1%, 33/54), and chloramphenicol (60.5%, 26/43). In contrast, lower resistance rates were observed for cefotaxime (37.0%, 20/54) and meropenem (20.4%, 11/54). Significant associated factors of blood stream infections included age < 1 year (AOR = 2.11; 95% CI: 1.46-2.86), fever duration > 7 days (AOR = 2.74; 95% CI: 1.22-6.15), partially immunized children (AOR = 3.21; 95% CI: 1.08-9.51; p = 0.036), and non-immunized children (AOR = 9.87; 95% CI: 3.61-26.9; p < 0.001).

CONCLUSION: The prevalence of bloodstream infections among febrile children under five years of age was high. Younger age, fever duration > 7 days, and partially immunization and non-immunization were significant predictors of bloodstream infection. Strengthening antimicrobial stewardship, improving immunization coverage, and enhancing early diagnosis are essential to reduce the burden of bloodstream infections and combat antimicrobial resistance.

PMID:42324521 | DOI:10.1186/s12887-026-07208-4

BMC Psychiatry. 2026 Jun 21. doi: 10.1186/s12888-026-08317-1. Online ahead of print.

ABSTRACT

BACKGROUND: Schizophrenia is a severe mental disorder characterized by complex clinical presentations and marked impairments in social and occupational functioning. While antipsychotic medications are effective in managing positive symptoms, their efficacy in addressing negative symptoms, cognitive deficits, and overall improvements in social functioning and quality of life remains substantially limited.This study aims to evaluate the effects of Baduanjin combined with Computerized Cognitive Remediation Therapy (CCRT) on patients with schizophrenia, thereby contributing to the evidence base for its clinical management.

METHODS: A total of 120 hospitalized patients with schizophrenia (aged 29-64 years; 66.67% male) were recruited and randomly allocated to either an intervention group (n = 60) or a control group (n = 60). Participants in the intervention group received a combined 85-minute session (45 min of CCRT plus 40 min of Baduanjin training) five times per week, whereas the control group received CCRT alone for the same duration. Assessments of psychiatric symptoms, cognitive function, social functioning, and quality of life were conducted at baseline and post-intervention.

RESULTS: Baseline characteristics were comparable between the two groups for all outcome measures (P > 0.05). Following the 8-week intervention, within-group analyses showed significant improvements from baseline in The Neurobehavioral Cognitive Status Examination(NCSE), The Scale of Social Function in Psychosis Inpatients( SSPI), and The Schizophrenia Quality of Life Scale(SQLS) scores for both groups (all P < 0.05). In contrast, a statistically significant reduction in The Positive and Negative Syndrome Scale(PANSS) total scores was only observed in the intervention group (P < 0.05). Moreover, intergroup analysis revealed that the intervention group demonstrated significantly greater improvements across all outcome measures (NCSE, SSPI, SQLS, and PANSS) compared to the control group post-intervention (all P < 0.05).

CONCLUSION: Patients with schizophrenia showed significantly better overall efficacy with an 8-week combined treatment of Baduanjin and CCRT compared to CCRT alone, particularly in improving psychiatric symptoms (especially negative symptoms), enhancing cognitive function, restoring social functioning, and improving quality of life.

CLINICAL TRIAL REGISTRATION INFORMATION: The study protocol of this investigator-initiated randomised controlled trial was formally registered with the ISRCTN registry (registration number: ISRCTN14037337) on 12 May 2026.

PMID:42324517 | DOI:10.1186/s12888-026-08317-1