Nevin Manimala

Nurs Health Sci. 2026 Mar;28(1):e70272. doi: 10.1111/nhs.70272.

ABSTRACT

Acute pain and chronic pain represent major global public health challenges; however, no data on their prevalence and determinants have been available in Albania. This study aimed to estimate the prevalence of both acute and chronic pain by gender, and to identify sociodemographic factors associated with chronic pain. A nationwide cross-sectional study was conducted, using a random cluster sampling method to recruit a representative sample of 380 families across all the regions of Albania. A total of 1424 participants completed a structured questionnaire. Descriptive statistics, univariate, and multivariate logistic regression analyses were performed to explore associations between chronic pain and potential predictors. Acute pain was reported by 39.8% of respondents, while chronic pain affected 37.1% of the sample. Multivariate analysis revealed that chronic pain was significantly associated with female sex (adjusted odds ratio (aOR) = 1.99; 95% confidence interval (CI): 1.07-2.26), age over 60 years (aOR = 2.55; 95% CI: 1.15-5.38), in particular range between 31 and 50 years old (aOR = 2.58; 95% CI: 1.71-3.88), low annual income (< €1000; aOR = 2.35; 95% CI: 1.13-5.30), who smoke/alcohol use (aOR = 0.42; 95% CI: 0.18-0.97). Over weight (OR = 2.36; 95% CI: 1.24-4.60) and to be cancer affected (OR = 2.63; 95% CI: 1.59-4.40) only in univariate analysis are associated with chronic pain. In both cases, these results are not confirmed in the multivariate analysis. This is the first study to assess the prevalence and determinants of pain in Albania. The findings highlight a substantial burden of untreated pain and underscore the need for equity-oriented public health strategies, integrated pain services, academic education strategies, and targeted interventions for vulnerable groups.

PMID:41457309 | DOI:10.1111/nhs.70272

Ital J Pediatr. 2025 Dec 28. doi: 10.1186/s13052-025-02148-8. Online ahead of print.

ABSTRACT

BACKGROUND: Head and neck area abscesses are severe bacterial infections that commonly arise as complications of viral upper respiratory tract infections in pediatric patients. These infections can affect various anatomical structures, including the tonsils, retropharyngeal spaces, paranasal sinuses, middle ear, and salivary glands. The most frequent clinical presentations include otomastoiditis, retropharyngeal abscesses, and periorbital cellulitis. Although traditionally considered rare in developed countries, in recent years, particularly in the post-COVID-19 (COronaVIrus Disease 19) pandemic period, we have observed a notable increase in these complications at our center.

METHODS: We conducted a retrospective, single-center epidemiological study on our cases of septic complications involving the head and neck region, comparing two three-year periods (from January to December): 2017-2019 and 2022-2024. Cases were classified into four categories: otomastoiditis, periorbital cellulitis, retropharyngeal abscesses, and other abscesses (including lateral cervical and cerebral abscesses). For each year the incidence rate of these complications was calculated in relation to the total number of hospital admissions. Statistical comparison was performed using the Chi-square test.

RESULTS: The comparison between the two three-year periods (2017-2019 vs. 2022-2024) revealed a dramatic increase in head and neck suppurative infections: 8 cases in 2017-2019 compared to 56 cases in 2022-2024. The incidence rose from 0.32% to 2.42%, a statistically significant difference (p < 0.01). The incidence rate peaked in 2024, reaching 3.3%. The most frequent complication was periorbital cellulitis, followed by otomastoiditis. Notably, in 2022, a case of cerebral abscess occurred, requiring transfer to intensive care.

CONCLUSIONS: Our study highlights an unexpected increase in head and neck suppurative-inflammatory complications. While recent publications have documented a rise in pediatric respiratory infections in the post-COVID-19 era, specific studies addressing the surge in these conditions remain scarce. This trend may be linked to the so-called COVID-19 immunity gap and/or to emerging patterns of antimicrobial resistance. However, given the retrospective observational design of our study, establishing a causal link is not possible. Pending further scientific evidence, enhanced surveillance remains essential to promptly identify these conditions, given their rapid progression and high morbidity.

PMID:41457294 | DOI:10.1186/s13052-025-02148-8

Parasit Vectors. 2025 Dec 29. doi: 10.1186/s13071-025-07217-9. Online ahead of print.

ABSTRACT

BACKGROUND: Mosquito-borne diseases cause significant burdens in rural areas of Southeast Asia. The lack of data on vector bionomics hinders disease control and elimination. The objectives of this study were to assess the diversity and biting behaviours of mosquito species biting humans and their livestock in the forest hills of Karen state, Myanmar, and to assess the patterns of species co-occurrence and the effects of the environment on vector abundance.

METHODS: Mosquitoes were captured over 24-h diel cycles in six villages in September 2019 using the human landing catch and cow-baited trap collection methods. Collected specimens were identified to the species level using dichotomous morphological keys. Environmental data were acquired through remote sensing. The analysis of biting times was performed with circular statistics. Species co-occurrence patterns and the effects of environmental variables on species abundance were assessed with a generalized linear latent variable model.

RESULTS: A total of 36,607 mosquitoes were captured, and 96 species in 16 genera were identified. The most abundant genera were Anopheles, Culex and Downsiomyia. Multiple malaria, arboviruses and lymphatic filariasis vector species were detected, and their biting behaviours were reported. Generalized linear latent variable modelling revealed two clusters of species that were positively correlated with one another. The first cluster included many Culex and Anopheles species, and Mansonia annulata, which breed in shallow, stagnant or slow-moving water, such as marshes, swamps, rice fields and the margins of streams and puddles. These species were negatively associated with elevation, slopes and forests and positively associated with grasslands, shrubs and crop fields. The second cluster included many rainforest mosquitoes of the genera Armigeres, Heizmannia, Downsiomyia, Anopheles dirus, An. jeyporiensis, Culex bitaeniorhynchus and Aedes pseudoalbopictus, which breed in tree canopies and in natural surface water and containers such as bamboo stumps, tree holes and rainwater pools. These species were positively associated with elevation, slope, dense forests, surface water and wetlands and negatively associated with crop fields, grasslands and shrubs.

CONCLUSIONS: Transmission dynamics are particularly complex in this setting where people are exposed to bites of numerous vector species throughout the diel cycle. Environmental factors shape the assembly of mosquito species communities and largely determine the risk of exposure to vector bites.

PMID:41457278 | DOI:10.1186/s13071-025-07217-9

BMC Med. 2025 Dec 28. doi: 10.1186/s12916-025-04604-y. Online ahead of print.

ABSTRACT

BACKGROUND: To explore the associations between clustering of cardiometabolic risk factors, physical activity (PA), and digital exclusion with depressive symptoms trajectories, and to assess whether PA and digital exclusion mediate these associations.

METHODS: This study included 8999 participants from the Health and Retirement Study (HRS, n = 4380) and the English Longitudinal Study of Ageing (ELSA, n = 4519). Cardiometabolic risk factors included waist circumference, high-density lipoprotein (HDL) cholesterol, systolic and diastolic blood pressure, type 2 diabetes mellitus, glycated hemoglobin (HbA1c), and C-reactive protein (CRP). Depressive symptoms, PA, and digital exclusion were assessed via self-report. Statistical analyses used multinomial logistic regression and the Karlson-Holm-Breen (KHB) method.

RESULTS: We identified three clustering of cardiometabolic risk factors and four depressive symptoms trajectories. Compared to participants classified as healthy obesity, those in the obesity-hypertension group had an OR of 1.26 (95% CI: 1.09-1.46) for the moderately severe depressive symptom trajectory, while those in the complex cardiometabolic group had an OR of 1.31 (95% CI: 1.08-1.58), 1.79 (95% CI: 1.45-2.23), or 2.19 (95% CI: 1.66-2.90) for the moderate, moderately severe, or severe depressive symptom trajectory, respectively. Compared to those with PA insufficiency and digital exclusion, among PA sufficient participants, the OR of being in the moderate, moderately severe, or severe depressive symptom trajectory was 0.74 (95% CI: 0.65-0.84), 0.57 (95% CI: 0.50-0.66), or 0.35 (95% CI: 0.20-0.61), respectively; among digitally engaged participants, the OR of being in the moderately severe or severe trajectory was 0.63 (95% CI: 0.53-0.75) or 0.42 (95% CI: 0.33-0.54), respectively. Compared with the healthy obesity group, those with sufficient PA or digital inclusion in obesity-hypertension and complex cardiometabolic groups had lower odds of depressive symptoms trajectories. Mediation analysis showed that PA and digital inclusion accounted for 12.5% and 6.67% of the association between clustering of cardiometabolic risk factors and the severe depressive symptom trajectory, respectively.

CONCLUSIONS: The obesity-hypertension was only associated with increased odds of the moderately severe depressive symptom trajectory, while the complex cardiometabolic pattern was associated with increased odds of depressive symptoms trajectories; in contrast, sufficient PA and digital inclusion were associated with reduced odds.

PMID:41457269 | DOI:10.1186/s12916-025-04604-y

Int J Health Geogr. 2025 Dec 28. doi: 10.1186/s12942-025-00448-0. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic displayed notable disparities in infection and mortality rates across populations, yet socioeconomic factors remain underexplored in many analyses. This study leverages an individual-level dataset from Cali, Colombia, detailing COVID-19 cases, vaccination histories, and mortality outcomes, to examine spatiotemporal vaccination patterns and their effects on mortality.

METHODS: Using a Bayesian two-part model with generalized linear mixed models, the analysis accounts for endogenous selection, individual heterogeneity, and spatial-temporal dependencies.

RESULTS: The findings highlight significant socioeconomic inequalities in vaccination coverage: individuals from higher socioeconomic strata were more likely to receive full vaccination regimens and booster doses, while those from lower strata faced reduced vaccination coverage and elevated mortality risks. Employment, socioeconomic status, and ethnicity emerged as key predictors of vaccination propensity and mortality, disproportionately disadvantaging vulnerable groups.

CONCLUSIONS: These results stress the need for equitable vaccine distribution and targeted interventions to address disparities and enhance public health outcomes.

PMID:41457268 | DOI:10.1186/s12942-025-00448-0

BMC Plant Biol. 2025 Dec 28. doi: 10.1186/s12870-025-07978-6. Online ahead of print.

ABSTRACT

BACKGROUND: Wood apple is a hardy yet underutilized fruit tree of the Indian subcontinent, valued for its nutritional, medicinal, and ecological significance. Despite its potential as a climate-resilient fruit species, the determinants of yield variability remain poorly characterized. This study aimed to quantify how morphometric descriptors of canopy architecture, floral, and fruit traits explain yield variation across 62 wood apple genotypes. By integrating multivariate statistics with explainable machine-learning models (Random Forest + SHAP), we provide the first data-driven framework for identifying trait combinations that govern productivity in this underutilized tree species. The approach offers a novel, interpretable path toward ideotype selection and precision orchard design.

RESULTS: Extensive morphometric variability was observed across the 62 genotypes for vegetative, foliar, floral, fruit and seed traits, indicating a broad genetic base. Yield per tree ranged widely from 35 to 127 kg, with a mean of 75 kg tree⁻¹. Principal Component Analysis (PCA) showed that canopy architecture, branch traits, and leaf-fruit attributes collectively explained 31.1% of the total variation. Correlation analysis revealed positive associations of yield with tree shape, pulp colour, and fruit-bearing tendency, whereas ornamental fruit traits and excessive spine density were negatively related. The optimized Random Forest (RF) model achieved strong predictive performance on the test dataset (R² = 0.84; RMSE = 9.45 kg; MAE = 7.12 kg), significantly outperforming Multiple Linear Regression (R² = 0.62), Support Vector Regression (R² = 0.76), and the Deep Learning (MLP) model (R² = 0.71). RF identified tree shape (16%), open flower colour (11.3%), and pulp colour (9.0%) as the most influential predictors of yield. SHAP analysis further clarified the non-linear and interactive effects among traits, highlighting the combined influence of canopy vigour, reproductive efficiency, and fruit-quality attributes on productivity. Hierarchical clustering grouped the genotypes into three clusters, with Cluster 2 characterized by compact canopies, superior reproductive traits, and desirable pulp features showing the highest and most stable yield (mean 84.6 kg tree⁻¹). Cluster 0 displayed moderate-to-high yields (79.7 kg tree⁻¹) but with greater variability, while Cluster 1 comprised the lowest-yielding genotypes (70.4 kg tree⁻¹). These findings confirm that productivity in wood apple is jointly regulated by architectural and reproductive traits through coordinated source-sink dynamics.

CONCLUSIONS: Wood apple yield is governed by an integrated suite of architectural and reproductive traits, rather than single descriptors. Genotypes with compact canopies, regular bearing habit, and consumer-preferred pulp characteristics emerge as promising ideotypes for high productivity and orchard efficiency. By combining Random Forest and SHAP, this study demonstrates the practical value of explainable machine-learning tools in identifying actionable trait combinations and providing a robust, trait-based framework to support data-driven breeding and climate-smart orchard design in underutilized perennial fruit crops.

PMID:41457267 | DOI:10.1186/s12870-025-07978-6

J Ovarian Res. 2025 Dec 29. doi: 10.1186/s13048-025-01945-3. Online ahead of print.

ABSTRACT

BACKGROUND: Autoimmune dysfunction is a recognized contributor to primary ovarian insufficiency (POI), and antinuclear antibodies (ANA) are widely used to assess autoimmune activity. Although many studies have examined the association between ANA and POI, their findings remain inconsistent. This meta-analysis aims to clarify the correlation between ANA positivity and POI and to evaluate the potential of ANA as a serological marker of autoimmune involvement in POI.

METHODS: We systematically searched PubMed, EMBASE, Cochrane Library, CNKI, VIP, and WanFang Data for case-control studies published up to August 2024. Manual reference screening was also performed. Studies comparing antinuclear antibody (ANA) positivity between women with primary ovarian insufficiency (POI) and controls were included. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity and publication bias were assessed using the I² statistic and Begg’s test.

RESULTS: According to the analysis of all 13 studies, ANA positivity was significantly associated with POI (OR 2.57, 95% CI: 1.62-4.08, Z = 4.001, P < 0.001). No significant heterogeneity was observed in the primary outcome (I² = 11.9%). Subgroup analyses revealed statistically significant associations in the following: (1) FSH > 40 U/L subgroup (OR = 2.74, 95% CI: 1.78-4.21, I² = 0%); (2) age < 35 subgroup (OR = 2.83, 95% CI: 1.73-4.63, I² = 3.8%); (3) indirect immunofluorescence (IIF) subgroup (OR = 3.22, 95% CI: 1.28-8.09, I² = 34.6%) and dot immunogold filtration assay (DIGFA) subgroup (OR = 3.84, 95% CI: 1.31-11.27, I² = 0%); (4) non-ovarian infertility controls (OR = 4.42, 95% CI: 1.25-15.60, I² = 0%), healthy controls (OR = 2.13, 95% CI:1.23-3.68, I² = 0%), and hypogonadotropic amenorrhea controls (OR = 6.62, 95% CI: 2.25-19.52, I² = 0%) groups.

CONCLUSION: ANA positivity is significantly associated with an increased risk of POI, supporting its potential role as a serological marker for early screening. Routine ANA testing may be particularly valuable in women under 35 years of age or with FSH > 40 IU/L. Future large-scale studies should focus on optimizing ANA detection methods (e.g., enzyme-linked immunosorbent assay [ELISA] vs. IIF), quantifying titers, and evaluating nuclear patterns to improve diagnostic accuracy and clinical applicability.

PMID:41457262 | DOI:10.1186/s13048-025-01945-3

J Health Popul Nutr. 2025 Dec 28. doi: 10.1186/s41043-025-01182-w. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic low-grade inflammation and insulin resistance are hallmark features of metabolic syndrome (MetS). The pathways through which healthy diets influence metabolic health outcomes remain unclear.

METHODS: This study utilized six cycles (2005-2016) of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). A total of 10,518 adults (≥ 20 years) with complete data on diet, metabolic risk factors, and relevant covariates were included. Dietary live microbe intake was quantified and categorized into three groups-low, medium, and high- on the basis of estimated colony-forming units in foods, as well as by categorizing the consumption of foods with medium/high microbial content (MedHi). MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multivariate logistic regression, restricted cubic spline analyses, and mediation analyses were performed to examine the associations and potential mechanistic pathways via inflammation [white blood cell (WBC) counts, neutrophil counts, serum albumin, and systemic immune-inflammation (SII) index] and insulin resistance [triglyceride-glucose (TyG) index and homeostatic model assessment of insulin resistance (HOMA-IR)].

RESULTS: Compared with the non-MedHi group participants, the risk of MetS was 17% lower (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.71, 0.98) in the high-MedHi food intake group. Compared with that of the low microbe food group, the risk of MetS was 16% lower (OR: 0.84, 95% CI: 0.72, 0.98) in the medium microbe food group. Mediation analysis indicated that the association between dietary live microbe intake and a reduced risk of MetS was mediated by improved systemic inflammation, but no significant mediating effect of insulin resistance was found.

CONCLUSIONS: Moderately increasing the intake of foods rich in high level microbes in the daily diet is associated with a reduced risk of MetS and may have potential benefits for maintaining stable blood pressure and blood lipid levels. Systemic inflammation markers, including the serum neutrophil counts and SII, partially mediate the association between dietary live microbe intake and MetS.

PMID:41457230 | DOI:10.1186/s41043-025-01182-w

Respir Res. 2025 Dec 29. doi: 10.1186/s12931-025-03467-4. Online ahead of print.

ABSTRACT

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease (ILD) with high mortality and a high prevalence of comorbidities. Hypertension is among the most common extrapulmonary complications, but the underlying mechanisms linking IPF and hypertension remain poorly understood. This study aimed to explore the potential causal relationship and shared immune-genetic mechanisms between IPF and hypertension.

METHODS: A real-world cohort of 110 IPF patients from Peking Union Medical College Hospital (PUMCH) was enrolled. Clinical comorbidity profiles were analyzed, and whole-exome sequencing (WES) was performed on peripheral blood samples. Two-sample Mendelian randomization (MR) analysis was conducted using PUMCH data and external GWAS summary statistics to assess the causal effect of IPF genetic susceptibility on hypertension. Functional enrichment, protein-protein interaction (PPI) networks, and immune pathway analysis were performed, followed by multi-tiered validation through qPCR, Western blotting, and immunohistochemistry.

RESULTS: Hypertension was observed in 61.8% of IPF patients and was independently associated with poor survival. Two-sample MR analyses based on both internal WES and external GWAS data supported a causal effect of IPF genetic susceptibility on hypertension. Enrichment analyses revealed involvement in antigen presentation and immune regulation. CD74, HLA-DPA1, and HLA-DRA were consistently downregulated in comorbid IPF and hypertension across GEO datasets and experimental validation, suggesting impaired antigen presentation as a key mechanistic link.

CONCLUSION: This study provides genetic and immunological evidence supporting a causal relationship between IPF and hypertension. Dysregulated antigen presentation may serve as a common pathogenic pathway, offering potential targets for precision comorbidity management in IPF patients.

PMID:41457226 | DOI:10.1186/s12931-025-03467-4

BMC Oral Health. 2025 Dec 28. doi: 10.1186/s12903-025-07397-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of the study was to compare the retentive force and deformation of conventional casting and selective laser melting (SLM) cobalt-chromium (Co-Cr) clasps assembly of removable partial dentures (RPD) following recurrent insertion and removal forces.

MATERIALS AND METHODS: A total of 12 RPD samples were used in this study, which were divided equally into two groups: Group A (indirect digital conventional casting) and Group B (direct digital SLM) Co-Cr clasp assembly. The retention was measured using a universal testing machine after the recurrent removal and insertion of the RPD. Deformation was measured using Geomagic Control X professional metrology software. The retention and deformation data were compared between the two groups using an independent sample t-test. The association between the variables was studied using the Pearson correlation test. A statistical significance was established at P < 0.05.

RESULTS: A statistically significant difference in retention was observed between the two groups. Direct digital SLM Co-Cr clasp assembly showed higher retention and lower distortion compared to the indirect digital conventional casting Co-Cr clasp assembly. A significant negative correlation (correlation coefficient=-0.807, p-value = 0.004) between deformation and retention suggests that increased deformation reduces the retention.

CONCLUSION: The direct digital SLM Co-Cr clasp assembly in the RPD showed higher retentive force and lower deformation than the indirect digital conventional casting Co-Cr clasp assembly in the RPD.

PMID:41457213 | DOI:10.1186/s12903-025-07397-x