Nevin Manimala

J Nephrol. 2025 Jun 19. doi: 10.1007/s40620-025-02286-6. Online ahead of print.

ABSTRACT

BACKGROUND: The Kidney Failure Risk Equation (KFRE) estimates the risk of kidney replacement therapy (KRT) at 5 years. Patients with diabetes mellitus are at high risk of KRT and death, a competing event. This study assesses the performance of the 5-year KFRE in patients with diabetes mellitus, compared to non-diabetic patients and considering age, in a cohort of patients evaluated by a nephrologist at a tertiary care center.

METHODS: The CKD-CAREMEAU cohort included all patients who visited a nephrologist for chronic kidney disease (CKD) before KRT between 2008 and 2017. The 5-year KFRE was calculated for each patient, based on their baseline characteristics. The study evaluated performance regarding discrimination and calibration, taking the patient’s diabetic status and age into account.

RESULTS: The study included 2935 patients with a median age of 73 [65-80] years, 1800 of whom were men (61%), and 1249 (43%) who were affected by diabetes. The incidence of KRT was higher in diabetic patients (167 (13%)) than in non-diabetic patients (184 (11%))(p = 0.04). Additionally, the death rate within five years after inclusion was not statistically higher for diabetic patients (351 (28%)) than non-diabetic patients (443 (26%))(p = 0.3). Diabetic status affected neither discrimination nor calibration. However, the equation overestimated the risk for higher-risk patients, especially among the elderly.

CONCLUSIONS: Our study found no difference in the 5-year KFRE performance between diabetic and non-diabetic patients. However, performance was worse for patients over 75 years old.

PMID:40536612 | DOI:10.1007/s40620-025-02286-6

Environ Monit Assess. 2025 Jun 19;197(7):774. doi: 10.1007/s10661-025-14220-1.

ABSTRACT

This study utilizes geospatial tools to assess the climate change vulnerability of the Ratnapura District, Sri Lanka, by examining three key dimensions: exposure, sensitivity, and adaptive capacity. Ratnapura is particularly prone to climate-related hazards, such as floods, landslides, and droughts, which pose significant threats to its socio-economic stability and environmental health. The assessment employs historical climate data and geographic information to develop exposure maps, while sensitivity is evaluated through an analysis of socio-economic and environmental conditions. Adaptive capacity is measured by examining local institutional frameworks and resource availability. The findings reveal high vulnerability levels, particularly in the Ratnapura and Kalawana Divisional Secretariat (DS) divisions, highlighting the urgent need for targeted adaptation strategies. This study demonstrates the effectiveness of geospatial analysis tools in conducting comprehensive climate vulnerability assessments, providing valuable insights for developing climate-sensitive policies, and enhancing disaster risk reduction efforts. The results offer a foundation for local and regional authorities to implement proactive measures to build resilience against climate change impacts.

PMID:40536594 | DOI:10.1007/s10661-025-14220-1

Mol Neurobiol. 2025 Jun 19. doi: 10.1007/s12035-025-05153-4. Online ahead of print.

ABSTRACT

Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease, and previous research has shown that T cell-mediated immunity plays a key role in PD pathology. Programmed cell death protein 1 (PD-1) is a type I transmembrane protein that inhibits T lymphocyte inflammatory activity, and PD-1 deletion can reduce dopamine levels in mouse brains. However, the clinical status of PD-1 in PD patients remains obscure. To understand the clinical role of PD-1, flow cytometry (FCM) was used to assess peripheral blood mononuclear cells (PBMCs) from 16 patients with Parkinson’s disease and 16 controls in our study. With respect to PD-1 expression on peripheral T lymphocytes, we found a statistically greater proportion of PD-1 on CD8⁺ T, CD4⁺ T, and T helper (Th) 1 cells in the PD group compared to the control group (p < 0.05), and the proportion of CD4⁺ PD-1⁺ T cells was positively correlated with Parkinson’s Disease Sleep Scale (PDSS) scores (r = 0.5277, p = 0.0454). Moreover, the PD patients had a lower percentage of CD3⁺ T cells (p = 0.0007) among PBMCs. Furthermore, the expression level of PD-1 was positively correlated with the expression of interferon-gamma (IFN-γ) in CD4⁺ T cell subsets from patients with PD (r = 0.6765, p = 0.0051) and total subjects (r = 0.4674, p = 0.0070), while there was no relationship between PD-1 and regulatory T (Treg) cells in the PD group. In conclusion, our results indicated that the PD-1 expression on peripheral T lymphocytes may be involved in the pathogenesis of PD.

PMID:40536591 | DOI:10.1007/s12035-025-05153-4

Clin Oral Investig. 2025 Jun 19;29(7):344. doi: 10.1007/s00784-025-06373-7.

ABSTRACT

INTRODUCTION: The objective of this study was to compare the quality of obturation in the mesial roots of mandibular molars with isthmuses, using Er, Cr: YSGG laser and sonic-activated irrigation, assessed by micro-CT scanning.

METHODS: Mesial canals of extracted mandibular molars were instrumented to a master apical file size of 20/V06. The final irrigation protocol included 2.5% NaOCl, 17% EDTA, and a final rinse with 2.5% NaOCl, applied with either sonic-activated or laser-activated irrigation using the WaterLase iPlus (BIOLASE, Inc, Foothill Ranch, CA). Canals were obturated with Bioceramic Sealer HiFlow (Brasseler, Savannah, GA) and gutta-percha cones. Micro-computed tomography scans were obtained before and after obturation to evaluate the quality of obturation, determined by the percentage of unfilled spaces in each irrigation group.

RESULTS: There was no statistically significant difference in baseline canal characteristics, including isthmus width, canal volume, root curvature, and Weine classification between the groups (p > 0.05). In the post-obturation evaluation with micro-CT, the mean percentage of unfilled spaces was higher in the sonic group (17.24%) than in the laser group (10.73%), showing a statistically significant difference (p < 0.05).

CONCLUSIONS: This study suggests that laser-activated irrigation may improve the quality of obturation in mandibular molars with isthmuses compared to sonic-activated irrigation.

CLINICAL SIGNIFICANCE: This study demonstrates that laser-activated irrigation can lead to a higher quality of obturation in conservatively instrumented canals by reducing the percentage of unfilled spaces. However, these findings should be cautiously interpreted, as the improved obturation quality observed may not directly translate to clinical outcomes. Further research is needed to determine if this advanteg influence long-term treatment success.

PMID:40536580 | DOI:10.1007/s00784-025-06373-7

Environ Monit Assess. 2025 Jun 19;197(7):770. doi: 10.1007/s10661-025-14260-7.

ABSTRACT

Plastic waste pollution poses a critical challenge for environmental sustainability and socioeconomic well-being and is a severe environmental problem that has a significant impact not only on the natural ecosystem but also on socio-economic issues. To solve problems related to plastic waste pollution, we must clearly understand the current situation and related issues arising from plastic pollution in the research area. In this study, plastic input and leakage were examined during pre- and post-monsoon periods in the coastal regions of Can Gio District. Fifty-seven transects with differing ambient population densities in the study area were investigated for litter leakage, along with evaluations of single-use plastic consumer goods at the point of sale. The results showed that population density and pre- and post-monsoon periods did not affect litter densities. The CEI values representing 75% of the study area were classified as “clean,” and the litter density values representing 75% of the survey area were below 0.16 items/100 m. Most single-use plastic consumer items are produced domestically, facilitating the implementation of extended producer responsibility regulations.

PMID:40536579 | DOI:10.1007/s10661-025-14260-7

Dent Traumatol. 2025 Jun 19. doi: 10.1111/edt.13072. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Insufficient motor coordination can predispose children to falls and, consequently, the occurrence of traumatic dental injuries (TDIs). The present study investigated the association between psychomotor development and TDI in preschool children.

MATERIALS AND METHODS: A cross-sectional study was conducted with 189 children aged three to six years in Diamantina, Brazil. Psychomotor development was assessed using the Test of Gross Motor Development-Second Edition (motor assessment) and a validated preschool version of the Mini-Mental State Examination (cognitive assessment). Parents/guardians answered a socioeconomic questionnaire. Anthropometric measures were determined using WHO growth curves to obtain the body mass index (BMI). Intraoral examinations were performed by a single examiner trained and calibrated for diagnosing TDI based on the criteria proposed by Andreasen, with radiographic evaluations conducted when necessary. Lip coverage, anterior open bite, arch shape, and overjet were also recorded. Descriptive statistics, the chi-square test, and Poisson regression (bivariate and multivariate) analyses were performed (95% CI, p < 0.05).

RESULTS: The prevalence of TDI was 50.3%. Delayed motor development (PR = 1.66; 95% CI: 1.25-2.22) and obesity (PR = 1.64; 95% CI: 1.10-2.45) were significantly associated with TDI in the adjusted model.

CONCLUSION: Delayed motor development and obesity were associated with TDI in preschool children.

PMID:40536023 | DOI:10.1111/edt.13072

Strabismus. 2025 Jun 19:1-5. doi: 10.1080/09273972.2025.2518296. Online ahead of print.

ABSTRACT

INTRODUCTION: Inferior rectus (IR) recession surgery is commonly performed for vertical strabismus, yet overcorrection risk remains high (21-50%) due to factors like lower lid retractors, suture dissolution, and muscle tension in thyroid eye disease (TED). This study aims to contribute novel insights by comparing clinical outcomes of IR recession using absorbable and non-absorbable sutures.

METHODS: A retrospective study (01/12/20-31/01/23) was conducted at a tertiary referral center on patients undergoing IR recession with absorbable or non-absorbable sutures. The following data were collected: absorbable vs non-absorbable suture use, age at operation, sex, date of operation, surgical indication, presence of TED, adjustable vs non-adjustable suture technique, surgeon training level, number of muscles recessed, IR distance recessed, and time from surgery to final follow-up.

RESULTS: Thirty-two IR recession procedures were evaluated (26 absorbable, 6 non-absorbable cases) with a mean follow-up of 3.6 months. Both groups achieved similar success in vertical deviation control with no significant difference in success rates for distance (p = .48) or near fixation (p = .21). Overcorrection occurred in 23.1% (absorbable) and 16.7% (non-absorbable) cases, with no statistical difference (p = .61). Logistic regression analysis was performed, which showed that TED (p = .99), surgeon training level (p = .20), adjustable sutures (p = .89) and number of muscles operated on (p = .28) did not significantly impact success for absorbable sutures.

CONCLUSION: This study demonstrates that IR recession surgeries using absorbable sutures yield outcomes comparable to those using non-absorbable sutures, with no significant difference in success rates and overcorrection rates consistent with existing literature. These findings suggest that absorbable sutures are equally viable in use for IR recession surgeries.

PMID:40536018 | DOI:10.1080/09273972.2025.2518296

Disaster Med Public Health Prep. 2025 Jun 19;19:e152. doi: 10.1017/dmp.2025.10080.

ABSTRACT

OBJECTIVES: Breastfeeding assumes critical importance in the aftermath of disasters such as earthquakes, as it provides all the essential nutrients required by infants, enhances their immune systems, and mitigates the risks associated with using contaminated water for formula preparation. This study investigates the experiences of breastfeeding mothers living in temporary shelters within the earthquake-affected region.

METHODS: A qualitative approach was employed to identify the challenges faced by breastfeeding mothers. The study’s sample included 14 mothers who met the inclusion criteria. Data were collected through a semi-structured interview form and analyzed using MAXQDA qualitative data analysis software, following Colaizzi’s 7-step method.

RESULTS: The mothers in the study ranged in age from 31-37 years, with their infants ranging from 10 days-6 months old. Based on the data gathered from the interviews, 4 main themes were identified: basic life needs (with sub-themes of housing, warmth, nutrition, hygiene/sanitation, sleep, and clothing), emotional difficulties (with sub-themes of shock, fear, crying, and stress), care difficulties (with sub-themes of challenges in accessing medication, constipation, diarrhea, reduced comfort, and decreased urine output), and breastfeeding difficulties (with sub-themes of breast rejection, breast engorgement, baby feeding issues, reduced milk production or interruption, and privacy concerns).

CONCLUSIONS: From the onset of the earthquake, mothers encountered significant challenges in breastfeeding their infants. In emergency and disaster situations, it is imperative that experienced health care personnel offer essential information and support to assist these mothers in navigating the difficulties they face.

PMID:40536007 | DOI:10.1017/dmp.2025.10080

Cogn Sci. 2025 Jun;49(6):e70078. doi: 10.1111/cogs.70078.

ABSTRACT

According to the cross-situational learning account, infants aggregate statistical information from multiple parent naming events to resolve ambiguous word-referent mappings within individual naming events. While previous experimental studies have shown that infant and adult learners can build correct mappings based on statistical regularities encoded in multiple learning situations in an experiment, other studies that use more naturalistic stimuli (e.g., real-world video) reveal poor performance in adults’ ability to infer the correct referent. Based on those results derived from more naturalistic stimuli, the cross-situational learning solution cannot be useful to solve the mapping problem in the real world because cross-situational statistics from the real world are much more ambiguous than those created in experimental studies. To examine the feasibility of cross-situational learning in everyday contexts, the present study aims to quantify visual-audio statistics from one of everyday activities-parent-child toy play. We analyze parent naming events in a video corpus of infant-perspective scenes during parent-child toy play in a naturalistic lab setting, where we found three distinct properties that characterize statistical regularities perceived by young learners: (1) there are a limited number of visual scene compositions perceived by young learners at the moments when they hear object names; (2) the frequencies of parent naming events are distributed in a skewed, Zipfian fashion; and (3) cross-situational statistics in naturalistic toy play are comparable to those used in laboratory experiments. Our results underscore the importance of quantifying the statistical regularities in the input from the learner’s perspective in order to shed light on the mechanisms supporting early word learning.

PMID:40535997 | DOI:10.1111/cogs.70078

Fam Pract. 2025 Jun 4;42(4):cmaf048. doi: 10.1093/fampra/cmaf048.

ABSTRACT

BACKGROUND: Sex workers face significant barriers to accessing health services, including stigma, economic constraints, and safety concerns. In Turkey, this group is often subjected to discrimination and prejudiced approaches when accessing sexual health services, which reduces the uptake of health services. This study aims to analyze the health care experiences of sex workers in depth.

METHODS: The study conducted semi-structured in-depth interviews with 16 women working as sex workers in Adana brothel in July-October 2024, and the data were analyzed through thematic analysis. Participants were selected through purposive sampling to ensure socio-demographic diversity.

RESULTS: Four main themes were identified through the analysis: Barriers to Access and Use of Health Services, Health Service Experiences and Satisfaction, Information and Awareness, and Emotional Situations. Participants indicated that they often preferred private health facilities due to difficulties in accessing public health services and long waiting times, but that these preferences were limited by cost.

CONCLUSIONS: Improving the quality of public health services and reducing costs may improve public health by encouraging this group to use health services.

PMID:40535989 | DOI:10.1093/fampra/cmaf048