Nevin Manimala

Implement Sci Commun. 2025 Dec 13. doi: 10.1186/s43058-025-00835-5. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about effective implementation processes by which counties can improve treatment services to keep people with mental illness and substance use disorders out of local jails. This study examines hypothesized implementation mechanisms (relationship building, performance monitoring, interagency coordination, capacity building, and infrastructure programming) as predictors of outcomes (improved community services) and as mediators of the effects of a national implementation intervention (Stepping Up [SU]), on community services.

METHODS: A survey was conducted of mental health, substance use, jail, and probation administrators in 519 U.S. counties, of which 328 counties participated in a national jail reform effort (SU). Survey data were combined with descriptive data from the U.S. Census Bureau. Predictors included hypothesized implementation mechanisms (performance monitoring, interagency coordination teams, creating integrated systems of care, capacity building, relationship building, and quality programming). Covariates included county sociodemographic characteristics (e.g., size of county, size of jail, etc.) and general county service characteristics (e.g., primary care physicians per capita, Medicaid expansion). Implementation outcomes included number of evidence-based practices (EBPs) and evidence-based mental health treatments (MH-EBTs) for individuals with mental illness involved with justice systems. Multilevel regression analyses examined cross-sectional: (1) effects of Stepping Up on outcomes; (2) effects of implementation mechanisms on implementation outcomes; and (3) implementation mechanisms as mediators of the effects of Stepping up on implementation outcomes.

FINDINGS: SU was found to significantly predict the number of EBPs and MH-EBTs controlling for various demographic characteristics of the counties. When implementation mechanisms were added to these models, SU is no longer statistically significant. Instead, two implementation mechanisms (performance monitoring and interagency coordination) and Medicaid funding significantly predicted the availability of both EBP and/or MH-EBT. Other factors that predicted MH-EBTs include relationship building size of the county, rate of primary care physicians, rate of MH providers in the county, and jail population size. Mediation models found that SU significantly predicted these evidence-based outcomes through implementation mechanisms except interagency coordination.

CONCLUSIONS: Little is known about the implementation mechanisms to decarcerate and build programming for mental health services in a county. SU is an important attribute to facilitate reform both directly and indirectly through implementation mechanisms. Counties can benefit from use of relationship building activities to advance policy and service reform efforts, identifying performance metrics of their system, and having infrastructure available to improve the availability of EBPs. Overall, policy changes are possible, but an emphasis should be on strategies that increase the availability of EBPs and MH-EBTs.

PMID:41390748 | DOI:10.1186/s43058-025-00835-5

Eur J Med Res. 2025 Dec 13. doi: 10.1186/s40001-025-03676-z. Online ahead of print.

ABSTRACT

BACKGROUND: Ustekinumab (UST), a monoclonal antibody that blocks the p40 subunit of both interleukin (IL)-12 and IL-23, is widely used in inflammatory bowel disease (IBD) treatment. As UST use continues to increase in real-world clinical practice, it is becoming increasingly imperative to establish a more comprehensive understanding of its safety profile. The aim was to assess the safety of UST treatment in patients with IBD.

METHODS: Data on adverse events experienced by UST-treated patients with IBD were extracted from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) for the period of Q4 2009-Q4 2024. Disproportionality was assessed using four statistical measures, including the reporting odds ratio, proportional reporting ratio, multi‑item gamma‑Poisson shrinker method, and Bayesian confidence propagation neural network model. Furthermore, a Weibull distribution analysis was conducted to model the time‑to‑onset of adverse events.

RESULTS: A total of 22687 reports identified UST as the primary suspect drug for IBD and covered 27 system organ classes (SOCs), with injury, poisoning and procedural complications (n = 13676), gastrointestinal disorders (n = 9563), and infections and infestations (n = 8035) being the three with the highest frequency. Positive signals led to the identification of potential adverse events that are not widely documented in the labeling, including urinary tract infections, seizures, hepatic enzyme upregulation, hepatic steatosis, cholelithiasis, cerebrovascular accidents, and transient ischemic attacks. Furthermore, UST‑related adverse events follow an early‑failure model, and their reports gradually decline as treatment duration lengthens.

CONCLUSIONS: This study provides comprehensive real-world insights into the safety of UST use in IBD treatment, corroborating known adverse reactions and identifying additional potential risks. Robust pharmacovigilance and long-term monitoring are essential to support personalized UST therapy and facilitate informed risk-benefit assessments.

PMID:41390741 | DOI:10.1186/s40001-025-03676-z

World J Emerg Surg. 2025 Dec 13. doi: 10.1186/s13017-025-00666-8. Online ahead of print.

ABSTRACT

BACKGROUND: Rib fractures, particularly multiple fractures, are common in patients with chest trauma and can lead to complications and an increased risk of mortality. Surgical treatment can improve patient prognosis, but fixation of nondisplaced fractures is often overlooked, and nonfixed nondisplaced fractures may undergo delayed displacement postsurgery. This study explored the risk of delayed displacement of nonfixed fractures during surgical treatment and its biomechanical mechanisms.

METHODS: A total of 105 patients with multiple rib fractures were included. CT scans were used to assess fracture displacement, and finite element analysis was applied to simulate the effect of thoracic movement on displacement.

RESULTS: Postoperatively, 56.1% of patients experienced delayed displacement, with posterior rib fractures being the most prone to displacement. Finite element analysis revealed that the posterior ribs exhibited the most significant displacement at the end of inspiration. Statistical analysis indicated that posterior rib fractures were associated with delayed displacement (OR = 0.225, p = 0.025).

CONCLUSION: Nonfixed, nondisplaced rib fractures are at high risk of delayed displacement postsurgery, particularly in the posterior rib region. Attention should be focused on posterior rib fractures to reduce delayed displacement and improve patient prognosis.

PMID:41390722 | DOI:10.1186/s13017-025-00666-8

BMC Med Inform Decis Mak. 2025 Dec 13. doi: 10.1186/s12911-025-03306-y. Online ahead of print.

NO ABSTRACT

PMID:41390721 | DOI:10.1186/s12911-025-03306-y

BMC Vet Res. 2025 Dec 13;21(1):703. doi: 10.1186/s12917-025-05142-8.

ABSTRACT

BACKGROUND: As common pets, rabbits are frequently brought to veterinarians for examination and medical care. Many diagnostic and surgical treatments require anesthesia, which is linked to a higher perioperative risk in rabbits than in dogs and cats.

OBJECTIVE: To assess the impact of a single 25 mg/kg oral dose of gabapentin on the depth and duration of anesthesia and hemodynamic stability of different anesthetic regimes.

METHODS: Twenty adult healthy New Zealand male rabbits weighing 2.5 ± 0.5 kg were used in this study randomly and equally divided using a computer-generated random number table into four groups: group A (gabapentin/xylazine/ketamine), group B (gabapentin/ketamine), group C (xylazine/ketamine), and group D (ketamine only). All experimental groups were evaluated through assessment of anesthetic depth, vital, hematological, and serum biochemical parameters.

RESULTS: Our data revealed the enhanced reflex suppression and prolonged recovery observed in the anesthetic regime of group (A) with short induction time and prolonged recovery with remarkable muscle relaxation.

LIMITATIONS: The study was limited by a small sample size (n = 20), which may reduce the statistical power and generalizability of the findings. Additionally, postoperative pain assessment using validated scoring tools was not performed, and the results should be interpreted with caution regarding long-term analgesic efficacy.

CONCLUSION: A single oral dose of gabapentin minimizes the ketamine’s catalepsy, reducing its induction time, delaying and improving the recovery.

PMID:41390715 | DOI:10.1186/s12917-025-05142-8

Sci Rep. 2025 Dec 13. doi: 10.1038/s41598-025-28997-1. Online ahead of print.

ABSTRACT

Mosquitoes of the Anopheles, Aedes, and Culex genera are responsible for transmitting major vector-borne diseases. Malaria remains a significant public health concern in Odisha, primarily due to the state’s conducive environment for Anopheles mosquito breeding. This study, conducted between March 2021 and February 2023 across 11 traditionally hyper-endemic districts in southern Odisha, aimed to assess seasonal variations in Anopheles diversity, composition, and abundance. A total of 10,807 Anopheles mosquito’s species were collected manually indoors (house dwellings and cattle sheds) and outdoors (burrows, vegetation, tree holes, and culverts). Morphological identification revealed 18 Anopheles species. An. subpictus was the predominant species during the summer of 2021, with (328; 42.99%), and during the rainy season, with (1151; 46.60%), although its prevalence declined in subsequent years. An. culicifacies, a primary malaria vector, exhibited a consistent presence with (780; 31.58%) in the rainy season of 2021 and (798; 38.35%) in the rainy season of 2022. An. varuna remained scarce during summer and rainy seasons but peaked sharply in winter, with the highest prevalence in winter 2021-2022 (730; 35.56%) and winter 2022-2023 (485; 25.18%). Diversity indices (Shannon’s, Simpson’s, Pielou’s) and Correspondence Analysis identified Ganjam as the district with the highest species diversity (1.26-2.2). Seasonal variation had a statistically significant impact on species diversity (p < 0.001), surpassing the influence of district level factors. These findings show that seasonality strongly influences Anopheles populations and highlight the need for localized, evidence-based vector control. Monitoring of mosquito diversity is vital for shaping malaria interventions suited to Odisha’s transmission ecology.

PMID:41390700 | DOI:10.1038/s41598-025-28997-1

Nat Commun. 2025 Dec 13. doi: 10.1038/s41467-025-67549-z. Online ahead of print.

ABSTRACT

Paddy rice exacerbates climate warming through greenhouse gas emissions but also cools the land surface by enhancing evapotranspiration. While the former effect has received extensive attention, the biophysical cooling effect remains poorly quantified, partly due to the lack of high-quality global paddy rice data. Here, we address this gap by developing a universal rice mapping framework that integrates the strengths of phenology-based and curve-matching methods to construct the global, long-term rice dataset (GlobalRice500) with daily temporal and 500 m spatial resolution. Our analysis reveals that paddy fields annually reduce daytime land surface temperature by 0.21 ($\pm$0.0057)-0.27 ($\pm$0.0063) °C during the growing season compared to other croplands, with stronger cooling observed in larger fields and partial spillover to surrounding landscapes. These findings provide robust evidence of the surface cooling effect of paddy rice and call for a comprehensive evaluation of its role in climate regulation.

PMID:41390686 | DOI:10.1038/s41467-025-67549-z

Nat Commun. 2025 Dec 13. doi: 10.1038/s41467-025-67218-1. Online ahead of print.

ABSTRACT

Inexpensive and accurate genotyping methods are essential to modern genomics and health risk prediction. Here we introduce QUILT2, a scalable and read-aware imputation method that can efficiently use biobank scale haplotype reference panels. This allows for fast and accurate imputation using short reads, as well as long reads (e.g. Oxford Nanopore Technologies (ONT) 1X, r2 = 0.937 at common SNPs), linked-reads and ancient DNA. In addition, QUILT2 contains a methodological innovation that is designed to enable imputation of the maternal and fetal genome using cell free non-invasive prenatal testing (NIPT) data. Using a UK Biobank reference panel and simulated NIPT data, we see accurate imputation of the mother (0.25X, r2 = 0.966, common SNPs) and modest imputation of the fetus (0.25X, r2 = 0.465, fetal fraction of 10%) at low coverage, with fetal imputation accuracy rising with coverage (4.0X, fetal r2 = 0.894). We show using simulated data that this could enable both GWAS and PRS for the mother and fetus, which could create clinical opportunities, and if phenotypes can be collected alongside clinical NIPT, the potential for large GWAS.

PMID:41390671 | DOI:10.1038/s41467-025-67218-1

BMC Pregnancy Childbirth. 2025 Dec 13. doi: 10.1186/s12884-025-08271-y. Online ahead of print.

ABSTRACT

OBJECTIVE: Intrauterine Adhesions (IUA), including Asherman’s Syndrome, are a significant cause of female infertility, while stem cell interventions emerge as a promising therapeutic strategy. This meta-analysis aims to systematically evaluate the effectiveness of stem cell interventions for IUA by analyzing various pregnancy outcomes.

METHODS: This meta-analysis systematically searched five databases (PubMed, Web of Science, EMBASE, Scopus, and ProQuest) to identify clinical studies on stem cell interventions for IUA and endometrial repair. Data on cumulative live birth, biochemical pregnancy, clinical pregnancy, implantation rate, early spontaneous abortions, and ectopic pregnancy were extracted and analyzed. Subgroup analyses were conducted based on disease type and stem cell intervention method.

RESULTS: Out of 211 identified records, 10 studies were included. The overall pooled proportion of cumulative live birth was 0.40 (95% confidence interval (CI): 0.22 to 0.60), with significant heterogeneity (I² = 46.2%). Subgroup analysis showed the highest live birth rates in “General IUA” (0.57) and with “Autologous Cells with Scaffold/Matrix” (0.5632). Controlled trials demonstrated a significant benefit of stem cell therapy for live birth (odds ratio (OR) = 2.2535, 95% CI: 1.1750 to 4.3221). The pooled proportion for cumulative biochemical pregnancy was 0.6053 (95% CI: 0.4445 to 0.7461) with no significant heterogeneity. For cumulative clinical pregnancy, the pooled proportion was 0.4605 (95% CI: 0.3425 to 0.5831), also with significant heterogeneity (I² = 36.9%). “General Intrauterine Adhesion” (0.6250) and “Autologous Cells with Scaffold/Matrix” (0.6207) showed the highest clinical pregnancy rates. Stem cell interventions significantly improved clinical pregnancy rates compared to controls (OR = 3.1277, 95% CI: 1.3802 to 7.0877). The overall implantation rate was 0.1200 (95% CI: 0.0549 to 0.2424). Early spontaneous abortions occurred at a pooled proportion of 0.1705 (95% CI: 0.1055 to 0.2637), and ectopic pregnancies at 0.0568 (95% CI: 0.0238 to 0.1293), with no significant heterogeneity in either.

CONCLUSION: Stem cell therapy appears to be a promising intervention for IUA and endometrial repair, particularly with autologous cells combined with a scaffold, though more high-quality, controlled trials are needed to confirm these findings and optimize treatment protocols.

PMID:41390638 | DOI:10.1186/s12884-025-08271-y

BMC Prim Care. 2025 Dec 13. doi: 10.1186/s12875-025-03145-w. Online ahead of print.

ABSTRACT

BACKGROUND: Scientific conferences reflect trends in Family Medicine research and education. In Germany, the annual congress program of the German Society of General Practice and Family Medicine (DEGAM) encompasses a wide range of topics and is publicly accessible. However, little is known about how research methodologies and topics evolve over time.

METHODS: All program items from the DEGAM conferences from 2014 to 2024 were analyzed. Using the Large Language Model GPT-5, each item was automatically categorized by research methodology and topic. Descriptive statistics were used to summarize trends.

RESULTS: A total of 2,869 program items were identified. Quantitative and interventional studies constituted 53.5% of all methodologies, while qualitative and mixed-methods accounted for 33.1%. The relative proportions remained largely unchanged over the eleven-year period, however future-oriented topics such as eHealth or sustainability do emerge. Although diverse topics were represented, they showed no clear methodological evolution in every topic.

CONCLUSIONS: This first exploratory analysis of a national Family Medicine conference series shows that, while the thematic range is broad, research methodologies remain stable. Therefore, as in patient care, academic Family Medicine is the ‘decathlon’ of health service research, too.

PMID:41390632 | DOI:10.1186/s12875-025-03145-w