Nevin Manimala

Sci Rep. 2025 Apr 3;15(1):11426. doi: 10.1038/s41598-025-94482-4.

ABSTRACT

Greenwashing-the deliberate exaggeration or fabrication of environmental claims-undermines trust, disrupts transparency, and poses a significant barrier to genuine progress toward sustainability. This scenario-based experimental study examines whether purchasing managers, key stakeholders in organizational procurement, can reliably differentiate between greenwashed and certified sustainable products. Using three carefully designed purchasing scenarios-laptops, safety gloves, and copy paper-responses were collected from 465 purchasing managers across the EU, a region notable for its regulatory emphasis on eco-certifications. The findings reveal no statistically significant differences in willingness to pay (WTP) for products with greenwashed claims versus those backed by stringent certifications, with average WTP values varying only slightly between groups. These findings highlight a critical vulnerability to greenwashing, even among experienced professionals, raising concerns about the credibility of sustainability claims in influencing procurement decisions. The study underscores the need for systemic reforms, including the standardization of certification systems and enhanced decision-making tools, to mitigate greenwashing’s pervasive impact and foster authentic corporate sustainability.

PMID:40181012 | DOI:10.1038/s41598-025-94482-4

Sci Rep. 2025 Apr 3;15(1):11400. doi: 10.1038/s41598-025-90987-0.

ABSTRACT

The role of sodium supplements and sex in the occurrence of exercise-associated hyponatremia (EAH) remains controversial. This study investigated hydration status in ultrarunners (19 males and 9 females) who completed seven marathons over seven consecutive days. Due to the limited number of female participants, no statistical comparison between sexes was performed. Plasma sodium concentration ([Na⁺]) and multiple hydration markers were assessed before, during, and after the race. Reported sodium supplement consumption showed no association with plasma [Na⁺]. An overall decline in plasma [Na⁺] was observed in females (regression slope = -1.278, p = 0.02) across the event, whereas no significant change was detected in males (slope = -0.325, p = 0.57). Additionally, no significant associations were found between plasma [Na⁺] and other monitored variables, including sodium supplement intake, pre-race hydration strategy, body mass, total body water, plasma osmolality, hematocrit, hemoglobin, urine specific gravity, urinary [Na⁺], thirst rating, or fluid intake reported pre-, during, and post-stage. No cases of symptomatic or asymptomatic hyponatremia were identified, suggesting that total fluid and sodium intake were adequate to maintain fluid-electrolyte balance and prevent EAH in both sexes.

PMID:40181011 | DOI:10.1038/s41598-025-90987-0

Sci Rep. 2025 Apr 3;15(1):11519. doi: 10.1038/s41598-025-89744-0.

ABSTRACT

The use of multimodal analgesia is a common practice in clinical settings, where a combination of drugs with different mechanisms of action is used to enhance the effectiveness of an analgesic and reduce its adverse effects. This study aimed to compare the efficacy of concurrent ibuprofen and paracetamol with alternate administration in the management of postoperative pain after the surgical removal of impacted mandibular third molars. A single-center, double-masked, parallel-group, randomized controlled clinical trial involved 56 patients undergoing scheduled surgical extraction of impacted mandibular third molars. Patients were randomly assigned to either Group A (Control), where they were instructed to take one tablet of ibuprofen 400 mg and two tablets of paracetamol 500 mg together every 8 h for 48 h, or Group B (Study), where they were instructed to take one tablet of ibuprofen 400 mg and two tablets of paracetamol 500 mg alternatively every 4 h for 48 h. The primary outcome measure was the intensity of postoperative pain, which was evaluated using a Visual Analogue Scale (VAS) ranging from 0 to 10. The secondary outcome measure was the timing of the onset of the analgesic effect, the duration of pain relief, the frequency of rescue drug administration, and the time interval between taking the recommended medication and the need for rescue medication. Investigators involved in analyzing the patients’ responses were blinded to the pain control regime used by the participants. Pain intensity during the first 48 h after the extractions showed that most participants experienced “some pain,” including 50% in Group A and 35.7% in Group B. The percentage of patients reporting “no pain” was higher in group B than in group A, although the difference was not statistically significant (p = 0.495). More than half of the participants (53%) in group A reported needing an extra dose in the 48-hour follow-up period, while 85% in group B reported pain relief (p = 0.002). When correlating the mean pain score to the complexity level, in patients with moderate complexity of extraction, higher pain scores were recorded in group B. The findings of this study show that the combination of Paracetamol and Ibuprofen are well-tolerated and effective option for post operative pain after surgical removal of mandibular third molars. Use of Paracetamol and Ibuprofen alternatively in the first 48 h showed a more effective pain control compared to concurrent use of these medications. However given the small sample size and patients recruited from a single center, multicenter studies with a bigger sample size and stratified complexity groups would enhance the generalizability of the findings.This trial protocol was registered with ClinicalTrials.gov (Registration No: NCT06514222 dated 23/07/2024).

PMID:40181005 | DOI:10.1038/s41598-025-89744-0

Sci Rep. 2025 Apr 3;15(1):11449. doi: 10.1038/s41598-025-94591-0.

ABSTRACT

To explore whether Methamphetamine-related disorders (MRDs) will cause the risk of cardiomyopathy in the future. This study used Taiwan’s Longitudinal Generation Tracking Database (LGTD) to conduct a 1:4 paired analysis of sex, age, and inclusion year. 17,071 patients with MRDs and 153 patients with cardiomyopathy were selected; 68,264 patients without MRDs and 274 patients with cardiomyopathy were also selected. This study used SPSS 22 statistical software to conduct Cox regression analysis. Patients with MRDs had a 3.421-folds higher risk of cardiomyopathy than patients without MRDs. Men have a 0.735-fold lower risk of developing cardiomyopathy than women. In terms of age group, aged 50-64 and ≧ 65 have a 1.145- and 1.332-folds higher risk of cardiomyopathy, respectively, compared to those aged 20-49. For each one-point increase in Charlson Comorbidity Index (CCI), the risk of cardiomyopathy rises by 58.3%. Specifically, for three types of Methamphetamines (Methamphetamine and other psychostimulant dependence, Methamphetamine or related acting sympathomimetic abuse, Methamphetamine psychosis), the HR for cardiomyopathy in patients with MRDs was 3.864 (p < 0.001), 2.916 (p < 0.001), and 2.295 (p = 0.016) times higher, respectively, compared to patients without MRDs. The Kaplan-Meier log-rank test was used to calculate the cumulative risk of MRDs, showing a significant difference in the cumulative cardiomyopathy incidence between the MRDs and non-MRDs groups (long-rank test, p < 0.001). MRDs will increase the risk of cardiomyopathy. Women are more susceptible to cardiomyopathy than men, and the risk escalates for individuals aged 50-64 and those 65 years or older, compared to the 20-49-year age group. Additionally, an increase in the CCI correlates with a heightened risk of cardiomyopathy. There are important differences between these groups in terms of duration, frequency, and severity of use, with longer exposure and more frequent use increasing the risk of dependence and psychosis, but individual susceptibility, dose, and use patterns also play key roles.

PMID:40180980 | DOI:10.1038/s41598-025-94591-0

Sci Rep. 2025 Apr 3;15(1):11465. doi: 10.1038/s41598-025-91871-7.

ABSTRACT

The biological processes involved in diseases like human immunodeficiency virus (HIV) and tuberculosis (TB) require extensive research, particularly when both diseases occur together. This piece of research delves to explore a new fractional-order mathematical model that examines the co-dynamics of HIV and TB, taking into account the treatment effects. Although no definitive vaccine or cure for HIV exists, antiretroviral therapy (ART) can slow disease spread and prevent subsequent complications. The basic properties of the fractional model in the Caputo sense, including existence, uniqueness, positivity, and boundedness, are proved using crucial mathematical tools. The disease-free and endemic equilibria are determined for the co-infection model, along with the basic reproduction numbers [Formula: see text] for TB and [Formula: see text] for HIV, using the next-generation matrix technique. A comprehensive analysis is conducted to determine the local and global stability of the disease-free equilibrium point by applying the Routh-Hurwitz criteria and constructing a Lyapunov function, respectively. The stability of the disease-free state is also verified graphically by considering different initial conditions and observing the convergence of the curves to the disease-free equilibrium point. Furthermore, the model is examined under different scenarios by varying the reproduction numbers, specifically when [Formula: see text] and [Formula: see text], and when [Formula: see text] and [Formula: see text]. Using actual data from the USA from 1999 to 2022, crucial parameters are estimated. The final fitting of the model with real data demonstrates how effectively the model framework aligns with the data. Finally, computational simulations are performed for different cases to illustrate the behavior of the model solutions by varying the fractional order derivative, as well as examining the solution’s behavior with respect to the stability points.

PMID:40180970 | DOI:10.1038/s41598-025-91871-7

Nat Commun. 2025 Apr 3;16(1):2921. doi: 10.1038/s41467-025-57940-1.

ABSTRACT

Escherichia coli is the most widely studied microbe in history, but the population structure and evolutionary trends of its extrachromosomal elements known as plasmids remain poorly delineated. Here we used long-read technology to high-resolution sequence the entire plasmidome and the corresponding host chromosomes from an unbiased longitudinal survey covering two decades and over 2000 E. coli isolates. We find that some plasmids have persisted in lineages even for centuries, demonstrating strong plasmid-lineage associations. Our analysis provides a detailed map of recent vertical and horizontal evolutionary events involving plasmids with key antibiotic resistance, competition and virulence determinants. We present genomic evidence of both chromosomal and plasmid-driven success strategies adopted by distant lineages by independently inheriting the same genomic elements. Further, we use in vitro experiments to verify the importance of key bacteriocin-producing plasmids for clone success. Our study has general implications for understanding plasmid biology and bacterial evolutionary strategies.

PMID:40180894 | DOI:10.1038/s41467-025-57940-1

Pain Pract. 2025 Apr;25(4):e70031. doi: 10.1111/papr.70031.

ABSTRACT

BACKGROUND: Pain from musculoskeletal pain conditions is often persistent, bothersome, and negatively impacts physical function. Individuals with musculoskeletal pain report difficulty with walking and regular activities. For some, this may be related to overly negative pain cognitions, such as pain catastrophizing and kinesiophobia. In a geographically and racially diverse sample, we examined relationships between pain catastrophizing, kinesiophobia, and multimodal physical function (i.e., self-report, performance-based, objective).

METHODS: Participants were sedentary adults with ≥3 months of chronic musculoskeletal pain. Participants completed self-report measures of pain catastrophizing (Pain Catastrophizing Scale), kinesiophobia (Tampa Scale of Kinesiophobia), and physical function (World Health Organization Disability Assessment Scale 2.0). Performance-based physical function was assessed in-clinic with the Six-Minute Walk Test (6MWT). Physical function was objectively measured with ≥4 days of ActiGraph wear outside the clinic. We conducted descriptive, correlation, and linear regression statistics in SPSS.

RESULTS: Higher levels of pain catastrophizing (β = 0.42) and kinesiophobia (β = 0.25) were significantly associated with worse self-reported physical function. Neither pain catastrophizing nor kinesiophobia were related to performance-based or objectively measured physical function. The direction and significance of relationships between pain catastrophizing, kinesiophobia, and physical function measures were consistent in unadjusted and adjusted regression models.

CONCLUSIONS: Pain catastrophizing and kinesiophobia are associated with an individual’s perceived physical functioning. Behavioral interventions designed to enhance physical function may benefit from including cognitive restructuring to challenge catastrophic thoughts about pain, as well as thoughts about injuring oneself or worsening pain with movement. More work is needed to understand why neither pain catastrophizing nor kinesiophobia were significantly associated with performance-based or objective assessment of physical function. It is possible that other pain-related cognitions, for example self-efficacy for pain control, or variables (e.g., in vivo pain catastrophizing, mood, stress, sleep) assessed closer in time to performance-based or objective measures of physical function are more relevant.

PMID:40180886 | DOI:10.1111/papr.70031

J Pediatr Urol. 2025 Mar 20:S1477-5131(25)00148-2. doi: 10.1016/j.jpurol.2025.03.010. Online ahead of print.

ABSTRACT

BACKGROUND: Hypospadias is one of the most common congenital anomalies observed in childhood and treated surgically. This study was designed to compare the postoperative analgesic efficacy of caudal block with sacral ESP block in children following hypospadias surgery.

METHODS: This study was designed as a single-center, prospective, randomized, controlled, double-blinded study. A total of 68 male patients were included in the study, and they were divided into two groups: one with sacral ESP (Group ESP) and the other with caudal block (Group C), each group consisting of 34 patients. FLACC (Face, Legs, Activity, Cry, Consolability) scores of all patients were observed and recorded during the first 24 h postoperatively. FLACC scores were recorded at 5 min, 30 min, and 1, 2, 4, 6, 12, and 24 h postoperatively.

RESULTS: The duration of analgesia in Group C (9.7 ± 2.8 h) was statistically significantly longer than in Group ESP (6.3 ± 1.6 h) (p < 0.001). FLACC scores in Group C (2.2 ± 0.5, 2.6 ± 0.6, 3.5 ± 1.5) were statistically significantly lower at 4 and 6 h and statistically significantly higher at 12 h postoperatively than those of Group ESP (2.7 ± 0.7, 4.1 ± 2, 2.7 ± 0.9) (p < 0.001). Group ESP (2.2 ± 0.4) mean FLACC value was found to be statistically significantly higher than that of Group C (1.9 ± 0.3) (p = 0.001). Patient relatives’ satisfaction rate in Group C was statistically significantly higher than in Group ESP (p = 0.001).

CONCLUSION: In the present study, we found that caudal block resulted in a longer duration of postoperative analgesia and lower FLACC scores than ESP block in pediatric patients who underwent hypospadias surgery.

PMID:40180872 | DOI:10.1016/j.jpurol.2025.03.010

Clin Breast Cancer. 2025 Mar 10:S1526-8209(25)00051-5. doi: 10.1016/j.clbc.2025.03.005. Online ahead of print.

ABSTRACT

INTRODUCTION: Forequarter amputation (FA) or Interscapulothoracic disarticulation is indicated in patients with invasive breast carcinoma (BC) in selected cases: primary resection of a locally advanced or recurrent tumor, Stewart & Treves syndrome (STS), or sarcoma secondary to radiation due to breast cancer (radiation-induced sarcoma, RIS). However, no studies have robustly evaluated the indications, results, complications, recurrence and overall survival in the context of FA in patients with BC.

MATERIAL AND METHODS: We performed a systematic review of 8 databases according to the PICOS and PRISMA methodology through December 31, 2022. Descriptive statistics are presented, and Kaplan‒Meier survival curves were generated and compared with the log-rank method.

RESULTS: We identified 54 articles and collected data from 100 patients. The intention of FA was curative for 48 patients (57.1%) and palliative in 32 (38.1%). The procedure was performed due to STS (35%), upper limb dysfunction (18%), lymphedema (10%), recurrent axillary tumors (10%) and RIS (9%). Complications were low. The survival rates at 12, 24, 36, and 60 months were 65.6%, 42.8%, 36.4%, and 32.4%, respectively. The main factors associated with survival were tumor’s condition (P = .05) and surgical intent (P < .001; multivariate analysis).

CONCLUSION: FA has few complications and attenuates symptoms in patients treated with both curative and palliative intent. Surgery is justified in select cases, such as locally advanced tumors, infiltration of axillary structures, upper limb lymphedema with loss of function, and STS and RIS, and often represents the best chance for local disease control and improvement in quality of life.

PMID:40180864 | DOI:10.1016/j.clbc.2025.03.005

Farm Hosp. 2025 Apr 2:S1130-6343(25)00027-3. doi: 10.1016/j.farma.2025.03.008. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the impact on improving the appropriateness of prescribing following a pharmaceutical intervention based on the review and optimisation of sulfamethoxazole-trimethoprim prescriptions.

METHODS: A before-after intervention study was conducted in a tertiary hospital. The first period, or intervention period, was prospective and ran from September 2021 to January 2022. The second or post-intervention period was retrospective and covered the period March-December 2022. In case of discrepancy between indication and prescribed and recommended dosage, the physician was notified and the degree of acceptance was recorded. In the post-intervention period, we retrospectively analysed the adequacy of the dosage, checking whether any intervention had been carried out by the Pharmacy Department. Statistical analysis was performed using the chi-square test.

RESULTS: During the intervention period, 69 prescriptions were analysed, and 18 were found to be inappropriate (26%), 12 related to Stenotrophomonas maltophilia infection. In the post-intervention period, 129 prescriptions were reviewed, and 12 were considered inadequate (9%). Statistical analysis of the results obtained in both periods (18/69 and 12/129) showed statistically significant differences (p = 0.0082).

CONCLUSIONS: Pharmaceutical intervention in the review and optimisation of prescriptions improves the use of sulfamethoxazole-trimethoprim. The results obtained provide evidence of the importance of pharmaceutical review of such prescriptions.

PMID:40180863 | DOI:10.1016/j.farma.2025.03.008