Nevin Manimala

Sci Rep. 2025 Apr 5;15(1):11732. doi: 10.1038/s41598-025-96081-9.

ABSTRACT

The intrinsic capacity (IC) and balance function of older adults are closely related to falls. IC is not only directly related to falls but may also play a mediating role in balance and falls. This study aims to explore the mediating role of IC in balance and falls. A total of 284 elderly patients were divided into fall group (n = 131) and non-fall group (n = 153) based on whether they had experienced falls. All patients underwent assessments of IC, including locomotion (SPPB), vitality (MNA-SF), sensory (self-reported vision/hearing), cognition (MOCA), and psychological status (SAS/SDS). Patients underwent the sensory organization test and limits of stability test. (1) Using fall history as a binary dependent variable and various balance indicators as independent variables, visual (VIS) (p = 0.011, OR 0.957), vestibular function (p < 0.001, OR 0.958), and direction control (p = 0.042, OR 0.967) were negatively associated with falls. (2) After incorporating IC scores, sensory function (p < 0.001, OR 0.154), SPPB (p = 0.003, OR 0.758), and SOT-Composite (p < 0.001, OR 0.900) were negatively associated with falls, while SAS (p = 0.008, OR 1.068) was positively associated with falls. (3) IC score mediated the relationship between movement velocity (MVL) and falls. Among the five dimensions of IC, the SPPB and the MNA-SF mediated the relationship between MVL and falls, and the SPPB mediated the relationship between maximum excursion (MXE) and falls. The SAS mediated the relationship between SOM, VIS and falls, while the SDS mediated the relationship between SOM, EPE and falls. There are multiple mediating effects of IC between balance function and falls.

PMID:40188249 | DOI:10.1038/s41598-025-96081-9

Sci Rep. 2025 Apr 5;15(1):11734. doi: 10.1038/s41598-025-94619-5.

ABSTRACT

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart defect where the pulmonary veins abnormally connect to the systemic venous circulation, rather than the left atrium (LA). This study retrospectively analyzed 48 children diagnosed with TAPVC from January 2014 to January 2024 to investigate how specific echocardiographic and morphological characteristics impact prognosis. Perioperative records, including echocardiography, computed tomography angiography (CTA) images, surgical details, and patient outcomes, were reviewed. Data were statistically analyzed using tools such as t-tests, Mann-Whitney U tests, χ² tests, and logistic regression. Key factors examined included age at surgery, anatomical subtype of TAPVC, presence of preoperative obstruction, surgical techniques used, and postoperative complications. By identifying the impact of these variables on survival rates and hospital recovery, the study aims to improve risk stratification and management strategies for better outcomes in children with TAPVC.

PMID:40188240 | DOI:10.1038/s41598-025-94619-5

NPJ Prim Care Respir Med. 2025 Apr 6;35(1):21. doi: 10.1038/s41533-025-00426-w.

ABSTRACT

We investigated healthcare avoidance during the first COVID-19 wave in a Dutch region with high infection rates. A mixed-method, multiphase study used (1) primary care electronic health records to identify patients, (2) questionnaires to capture patients with unreported COVID-19 symptoms, and (3) interviews om care avoidance. Additionally, a natural language model estimated COVID-19 incidence from routine care data. Of 2361 respondents (39% response rate), 535 (23%) reported COVID-19 symptoms; 180 sought help, mainly from GPs. Care-seeking rates did not differ significantly between those with or without relatives who experienced severe illness or death before their own illness (p = 0.270). Interviews showed the main barriers were feeling not ill enough and concerns about an overstressed healthcare system, especially GPs. Only a third of participants with symptoms sought help, mostly from GPs. Serious illness or death of loved ones had no significant impact. Findings highlight the need for clear communication and accessible healthcare, including telemedicine, for future pandemics.

PMID:40188237 | DOI:10.1038/s41533-025-00426-w

Sci Rep. 2025 Apr 5;15(1):11670. doi: 10.1038/s41598-025-96852-4.

ABSTRACT

Millions of people worldwide suffer from heart failure, which is a serious public health concern that results in high medical costs from prolonged hospital stay. This study aimed to assess the determinant factors associated with prolonged hospitalization among admitted acute heart failure at Jimma Medical Center, south west Ethiopia. The study was conducted at Jimma Medical Center in Ethiopia from December 2023 to April 2024, employing a prospective observational design. Statistical analysis was performed using Epi-data V.4.6 and STATA V.17 and multiple linear regression was employed. T test and ANOVA were conducted and a p-value is deemed significant if it is less than 0.05, corresponding to a 95% confidence interval. A total of 294 individuals were enlisted, with a mean age of 56. Over half of the patients (53.4%) stayed eight days or more throughout their average 11.4-day hospital stay. The following were significant risk factors for extended hospital stays: living in a rural; being admitted to a cardiac unit having neck vein distension, having a third heart sound, having ankle edema; having hepatomegaly, and having pleural effusion were predictor’s of length of hospital stay. Based on this finding, the length of hospital stay in heart failure patients is influenced by various factors. Addressing these factors can help reduce the duration of hospitalization. Implementing targeted interventions, such as improving physical activity, managing comorbidities, and enhancing discharge planning, may lead to better patient outcomes and decrease the prolongation of hospital stays for those with heart failure.

PMID:40188231 | DOI:10.1038/s41598-025-96852-4

Int Urol Nephrol. 2025 Apr 5. doi: 10.1007/s11255-025-04494-2. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to assess the associations between serum salusins levels and atherosclerosis, endothelial dysfunction and cardiac morphology in autosomal dominant polycystic kidney disease (ADPKD).

METHODS: This study comprised 83 patients with ADPKD, and 53 healthy individuals. Salusin α and β levels were measured by ELISA. Echocardiography, flow-mediated vasodilatation, and carotid artery intima-media thickness measurements were conducted.

RESULTS: Serum salusin α levels were significantly lower and the salusin β/α ratio was significantly higher in the patient group compared to Controls [2.64 (1.83-3.30) pg/mL vs. 3.20 (2.55-7.87) pg/mL, P = 0.002 and 2.81 (2.30-3.54) vs. 2.64 (2.02-3.18), P = 0.041, respectively]. Patients were further categorized into two groups: Group 1 (eGFR ≥ 60 mL/min/1.73 m²) and Group 2 (eGFR = 59-15 mL/min/1.73 m²). The salusin α level was 2.31 (1.73-3.24) pg/mL in Group 2 and 2.72 (1.94-3.32) pg/mL in Group 1. In the correlation analysis performed in Group 2, there was a statistically significant negative correlation between salusin α and left ventricular mass (LVM) and LVM index (P = 0.019, P = 0.015, respectively), as well as a statistically significant positive correlation between salusin β/α ratio and LVM (P = 0.004) and LVM index (P = 0.025). In Group 1, a statistically significant positive correlation was detected between proteinuria and salusin β (P = 0.036).

CONCLUSION: In patients with ADPKD, salusin α was found to be significantly lower, while salusin β/α ratio was found to be significantly higher compared to healthy individuals. Low salusin α levels and high salusin β/α ratio were associated with LVM in advanced stages of ADPKD and salusin β was associated with proteinuria in early stage of ADPKD patients.

PMID:40188198 | DOI:10.1007/s11255-025-04494-2

Sci Rep. 2025 Apr 5;15(1):11736. doi: 10.1038/s41598-025-96774-1.

ABSTRACT

TERT promoter mutation is associated with poor prognosis in differentiated thyroid carcinoma, with US features varying by mutation status. However, this correlation in anaplastic thyroid carcinoma (ATC) is understudied. We investigated the association between clinicopathological characteristics and US features of ATC with TERT mutation status and prognosis. From November 1994 to May 2022, 58 ATC nodules from 58 patients were analyzed. Two radiologists retrospectively reviewed US features based on the revised K-TIRADS and ACR-TIRADS. Of all 58 ATC nodules, 32 nodules were tested for TERT promoter mutation and detected in 11. TERT promoter-mutated ATC was larger than TERT wild-type ATC (p = 0.032); however, no other differences were observed. ATC with survival period of less than 12 months were more likely to have lymph node metastasis (p = 0.012) or distant metastasis at diagnosis (p < 0.001), larger size on US (p = 0.005), and suspicion for gross extrathyroidal extension on US (p = 0.04) compared to ATC with survival period of 12 months or more. Advanced disease at diagnosis was a critical factor associated with 1-year survival in patients with ATC, whereas the TERT promoter mutation status was not.

PMID:40188170 | DOI:10.1038/s41598-025-96774-1

Psychiatr Q. 2025 Apr 5. doi: 10.1007/s11126-025-10135-9. Online ahead of print.

ABSTRACT

This study aimed to determine the pathways linking cognitive flexibility to fatigue through the serial mediation effect of sleep quality and sleepiness in 564 healthy adults using various scales, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Chalder Fatigue Scale, and Cognitive Flexibility Inventory. Analysis was performed using two mediating variables (sleep quality and sleepiness) with age and gender as covariates. The simple mediation effect was evaluated using the Causal Step. The indirect effect was examined using bootstrap method and Sobel test. The total and direct effects of cognitive flexibility on fatigue were both found to be statistically significant. The research model revealed three significant indirect effects: cognitive flexibility affecting fatigue through sleep quality, cognitive flexibility affecting fatigue through sleepiness and cognitive flexibility affecting fatigue through both sleep quality and sleepiness. Additionally, serial mediation analysis showed that the relationship between cognitive flexibility and fatigue is sequentially mediated by sleep quality and sleepiness (B = -0.064, SE = 0.013, 95% CI: -0.070 to -0.017). All effects were confirmed through the 95% confidence intervals, which did not include zero, and with significant p values. These findings highlight the role of sleep quality and sleepiness as serial mediators of the relationship between cognitive flexibility and fatigue. The study’s major contribution is to provide insight on the independent and serial mediating role of sleep quality and sleepiness in the relationship between cognitive flexibility to fatigue.

PMID:40186847 | DOI:10.1007/s11126-025-10135-9

Environ Monit Assess. 2025 Apr 5;197(5):512. doi: 10.1007/s10661-025-13971-1.

ABSTRACT

Rapid identification of contaminant source information is critical for solving sudden groundwater contamination events. This paper constructs a combined EnKF-SPSO algorithm based on the ensemble Kalman filter (EnKF) and survival particle swarm optimization (SPSO) algorithms to groundwater contamination source identification, which includes determining the location of the source, initial concentration, and emission time. The proposed hybrid architecture improves upon conventional single-algorithm approaches by decoupling the identification process into two stages. First, the EnKF searches for the contaminant source’s location, thereby reducing the search space. Next, the SPSO estimates the initial concentration and emission time within the reduced domain. This two-stage process effectively mitigates the curse of dimensionality often encountered in standalone optimization methods. We set up two solute transport scenarios with different numbers of contaminant sources to examine the effectiveness of the algorithm and compare it with the EnKF, particle swarm optimization (PSO), and SPSO algorithms. The results show that the EnKF-SPSO algorithm can identify the contaminant characteristics more accurately without falling into a local optimum, and the average relative error is less than 1%. In addition, the EnKF-SPSO algorithm, for cases with measurement errors, is highly reliable. The combined algorithm can provide technical support for groundwater contamination remediations, risk assessments, and liability determinations.

PMID:40186844 | DOI:10.1007/s10661-025-13971-1

J Community Health. 2025 Apr 5. doi: 10.1007/s10900-025-01463-9. Online ahead of print.

ABSTRACT

This study assesses the livelihoods of waste pickers and the potential health challenges they face, with the primary goal of informing policy development and interventions in Lagos State, Nigeria. A total of 1,274 waste pickers across 20 local governments in Lagos State were interviewed using a structured questionnaire. The data collected were analyzed using descriptive and inferential statistics with SPSS for Windows. Results indicated that most waste pickers were male (69%) and aged between 18 and 40. Common hazards faced by waste pickers included harassment (19%), injuries (13%), accidents (11%), and burns (7%). Despite these hazards, 50% of waste pickers earned between ₦30,001 and ₦50,001 (approximately $23-38.5) per month, with only a few earning above ₦50,000. Additionally, 70% of respondents reported having savings. Respondents highlighted several measures to improve their livelihoods, including recognition, security, financial support, empowerment, and job opportunities. As a result, 71% of waste pickers expressed willingness to leave their jobs if empowered. The major hazards encountered by waste pickers include harassment (19%), injuries (13%), accidents (11%), and burns (7%).

PMID:40186839 | DOI:10.1007/s10900-025-01463-9

Environ Monit Assess. 2025 Apr 5;197(5):509. doi: 10.1007/s10661-025-13931-9.

ABSTRACT

Pakistan, located in an arid region characterized by low rainfall and high temperatures, faces significant vulnerability to climate change. The country’s diverse meteorological conditions pose significant challenges for effective climate modeling. This study focuses on analyzing long-term meteorological time series data (1981-2020) from various regions across Pakistan to examine regional climate variability and detect emerging weather trends. Seventeen climate indices were calculated to assess weather patterns, followed by trend analysis utilizing both parametric and non-parametric methods. The parametric approach employed ordinary least squares (OLS) regression, while the non-parametric methods included the Mann-Kendall (MK) test and Sen’s Slope (SS) estimator. Over the 40-year period, the analysis revealed significant trends, such as increases in hot days, cold nights, warm nights, and extreme precipitation events. These findings emphasize the distinct and complex regional impacts of climate change in Pakistan. By identifying these trends through robust statistical techniques like OLS, MK, and SS, the study provides critical evidence of climate shifts, emphasizing the urgent need for tailored, region-specific strategies to strengthen resilience against the adverse effects of climate change.

PMID:40186819 | DOI:10.1007/s10661-025-13931-9