Nevin Manimala

Zhonghua Liu Xing Bing Xue Za Zhi. 2025 Jun 10;46(6):1043-1050. doi: 10.3760/cma.j.cn112338-20241211-00788.

ABSTRACT

Objective: To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance. Methods: Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher’s exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results: Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) (χ²=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions: The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

PMID:40518400 | DOI:10.3760/cma.j.cn112338-20241211-00788

Enferm Intensiva (Engl Ed). 2025 Jun 14;36(3):500544. doi: 10.1016/j.enfie.2025.500544. Online ahead of print.

ABSTRACT

INTRODUCTION: Acute kidney injury (AKI) is a frequent complication in Intensive Care Unit (ICU) patients with high morbidity and mortality.

OBJECTIVE: To analyze the incidence of mechanical and metabolic adverse events associated with continuous renal replacement therapy using sodium citrate as a regional anticoagulant.

MATERIAL AND METHODS: Observational, descriptive and prospective study performed in a polyvalent ICU during three years. Patients with AKI treated with renal replacement therapy and sodium citrate (Prismocitrate 18/0 mmol/L [0.5%]) were included. Patients with liver failure, active bleeding, severe thrombocytopenia, ICU stay of less than 24 h or treated with other anticoagulants were excluded. Demographic variables, severity index (APACHE II), vasoactive drug use, adverse events, and catheter characteristics were recorded. Anticoagulation efficacy was assessed with filter duration. Statistical analysis was performed with SPSS v.28.0, with P < .05 as the significance level. The study was approved by the ethics committee and informed consent was obtained from the patients or their relatives.

RESULTS: We studied 100 patients, 62% men, with a mean age of 63 ± 14.5 years. The main causes of AKI were septic shock, hemorrhagic shock and Covid-19. The median ICU stay was 16 days (RIC 8-43), with intra-ICU mortality of 48%. Therapy lasted a median of 60.5 h (RIC 38-107). Only one patient presented bleeding, and in 26% the filter coagulated. There were no cases of citrate toxicity. Electrolyte complications included hypocalcemia (45%), hypokalemia (41%), hyponatremia (36%) and metabolic acidosis (30%).

CONCLUSIONS: Mechanical and metabolic complications are common in continuous renal replacement therapies with sodium citrate. It is essential for ICU staff to be aware of their high prevalence in order to optimize clinical management.

PMID:40517456 | DOI:10.1016/j.enfie.2025.500544

Eur J Public Health. 2025 Jun 15:ckaf040. doi: 10.1093/eurpub/ckaf040. Online ahead of print.

ABSTRACT

Healthcare claims data are increasingly used to derive chronic condition (CC) surveillance indicators, although comparative evidence with self-reported data remains scarce. We explored the agreement and comparative validity (concurrent and predictive) of 20 CC prevalence indicators independently constructed using the French National Health Data System (SNDS) and Health, Health Care, and Insurance Survey (ESPS 2010-2014). Individual data from 5039 ESPS participants aged ≥25 years, representative of the 2010 French general population, were linked to the SNDS. Follow-up data included a 2014 health self-assessment and 5-year mortality. We considered 20 CCs with corresponding SNDS case-identifying algorithms and self-reported information from ESPS, including most cardiovascular diseases and frequent cancers. Kappa statistics assessed agreement between CC indicators across databases. Polytomous and dichotomous logistic regression assessed determinants of disagreement between sources and associations of indicators with health outcomes (concurrent and predictive validity). Prevalence values were much higher with survey data except for hypertension, diabetes, thyroid disorders, epilepsy, and most cancers for which they were closer (±20%) to claims data. Agreement between CC indicators varied from the strongest (hypertension, diabetes, thyroid disorders, most cancers) to the weakest (cardiac rhythm disorders, peptic ulcer, chronic liver diseases). Sex, age, and multimorbidity strongly influenced agreement. Most claims database indicators were more strongly associated with health outcomes. Health interview surveys and healthcare claims-derived indicators are not interchangeable given their specific determinants. Since no general rule applies to all CCs, the advantages and disadvantages of each data source should be closely considered in case-to-case analysis.

PMID:40517434 | DOI:10.1093/eurpub/ckaf040

Orv Hetil. 2025 Jun 15;166(24):930-941. doi: 10.1556/650.2025.33324. Print 2025 Jun 15.

ABSTRACT

Bevezetés: Az egészségügyi dolgozók elleni erőszak a kórházak minőségbiztosítása miatt gyakran kutatott terület. A gyermekkórházakra vonatozó kutatások száma azonban kevesebb. A munkahelyi erőszak hatása csökkenti a kórházi szolgáltatás hatékonyságát. Az agresszió észlelése szociálpszichológiai folyamat, különösen érdekes akkor, ha az interakcióban beteg gyermek is jelen van. A hozzátartozók és a betegek erőszakos magatartásmintáin kívül az agresszió egyébként is jelen van az egészségügyi dolgozók munkahelyen töltött mindennapjaiban bullyng formájában. Célkitűzés: A részletes leíró statisztikán túl, kutatásunkban megvizsgáltuk a dolgozók demográfiai adatai és az észlelt munkahelyi erőszak közötti kapcsolatot. Emellett kitértünk a dolgozói helyzetértékelésre, valamint a sürgősségi ellátás jellegzetességeire. Módszer: Exploratív keresztmetszeti kutatásunkba 266 egészségügyi dolgozót vontunk be (81,2% nő, átlagéletkor 42 év). A kutatócsoportunk által összeállított online kérdőívbe a demográfiai és a munkavégzéssel kapcsolatos kérdéseken túl beépítettük a Magyarországon is már többször felhasznált Nyílt Agresszió Skála elemeit is, amelyeket a vizsgálat helyszínéül szolgáló, központi elhelyezkedésű gyermekkórház sajátosságaihoz igazítottunk. A mérőeszközbe beépítettük egy korábban a kórházban végzett, a munkahelyi erőszakra irányuló kutatás eredményeit is. A kérdőíves felmérést orientációs beszélgetések előzték meg a kórház összesen 32 szervezeti egységében. Eredmények: A nemzetközi kutatási eredményekkel összhangban azt tapasztaltuk, hogy a kórházban a leggyakrabban észlelt erőszaktípus egyéves prevalenciája a betegek részéről 60,1%, a hozzátartozók felől 78,7%, valamint a kollégák irányából 53,8%. Mind a három kategóriában a verbális megnyilvánulások voltak a leggyakoribbak. A négy leginkább észlelt magatartásminta mindhárom tanúsítói csoport vonatkozásában a kiabálás, a sértegetés, a káromkodás és a becsmérlő fenyegetés volt. A legnagyobb kockázati profilú dolgozók ápolói végzettséggel rendelkező, beosztott szakdolgozók voltak, akik állandó nappalos vagy nappali és éjszakai váltakozó beosztásban látják el feladatukat, főleg fekvőbetegekkel foglalkoznak, másodállást vállalnak, és anyanyelvükön kívül beszélik az angol nyelvet is. A helyzetértékelést tekintve a válaszolók (n = 149) 23%-a romló, 70%-a stagnáló, míg 7%-a javuló tendenciát tapasztalt a megkérdezés előtti fél évben. A sürgősségi ellátásban dolgozók 100%-a tapasztalt valamilyen verbális agressziót a hozzátartozók irányából, és ez nagyobb mértékűnek mutatkozott, mint a máshol dolgozók esetében (82%). Megbeszélés: A Heim Pál Országos Gyermekgyógyászati Intézetben is körülírható volt az egészségügyi dolgozók elleni erőszak észlelése és a demográfiai változók kapcsolata. Ennek tekintetében azonban külön ügyelni kell a gyermek-hozzátartozó-ellátó kommunikáció sajátosságainak értelmezésére. Következtetés: Általánosságban elmondható, hogy az alacsonyabb beosztású egészségügyi dolgozók érintkeznek gyakrabban a betegekkel és a hozzátartozókkal olyan élethelyzetben, amikor megnyilvánulhat a munkahelyi erőszak. Az interakció észlelésére különböző előjelű hatással bír a stressz, a munka megszervezése, az építészeti környezet, az agresszív magatartások jelentésének lehetősége, az esemény utáni ’debriefing’ (a tapasztalatok megbeszélése), az ’anti-bullying’ (bántalmazás elleni) protokoll megléte és a deeszkalációs technikák ismerete. Orv Hetil. 2025; 166(24): 930–941.

PMID:40517377 | DOI:10.1556/650.2025.33324

Discov Oncol. 2025 Jun 15;16(1):1113. doi: 10.1007/s12672-025-02956-8.

ABSTRACT

INTRODUCTION: Ovarian cancer (OC) is a highly aggressive malignancy characterized by a complex immune microenvironment. B cells, essential components of immunological regulation, have been implicated in the progression of ovarian cancer. However, the precise mechanisms by which B cells and immune molecules influence ovarian cancer risk remain poorly understood.

METHODS: This study employed single-cell RNA sequencing (scRNA-seq) to analyze peripheral blood mononuclear cells (PBMCs) from ovarian cancer patients and healthy donors. Differential gene expression analysis identified CD14 as a critical gene in B cells. Mendelian randomization (MR) analysis, using exposure data from eQTL and pQTL databases, was performed to evaluate the association between CD14 and ovarian cancer risk. Mediation analysis was conducted to assess the role of CD80 on myeloid dendritic cells in mediating the relationship between CD14 and ovarian cancer.

RESULTS: The analysis demonstrated that CD14 expression was significantly downregulated in B cells from ovarian cancer patients compared to healthy donors. MR analysis revealed a significant association between elevated CD14 expression and reduced ovarian cancer risk. Mediation analysis indicated that CD80 mediated 26.2% of this effect.

CONCLUSION: These findings highlight CD14 as a key regulator of ovarian cancer risk, with CD80 serving as a mediator of the immune response in this context. This study provides insights into potential immune modulation strategies for ovarian cancer therapy.

PMID:40517355 | DOI:10.1007/s12672-025-02956-8

Plant Dis. 2025 Jun 14. doi: 10.1094/PDIS-05-24-0966-PDN. Online ahead of print.

ABSTRACT

The tea plants (Camellia sinensis), one of the earliest cultivated woody crops with numerous varieties, have a rich history of cultivation in China. However, tea plantations (23°55’11″N, 116°42’4″E) in Chaozhou, Guangdong Province, a leading tea production and export region, face a severe disease outbreak. Approximately 50-60% of tea plants in this area exhibit stem swelling, canker, and eventual dieback symptoms. Ten diseased stem samples were collected from the affected plantations to investigate the causal agent. Isolation was carried out within three days of collection. Hyphae grown out from the xylem of the infected tissues were recovered and incubated on potato dextrose agar (PDA) plates for four weeks in the dark. A total of 53 isolates were obtained from diseased branches. The colonies were villous; initially, the colony’s center was white, and the edge was olive. As it grew, dark pigmentation was produced, which caused the center to turn olive and the edge to turn greenish-black. When the sporulation in PDA media was absent, a piece of mycelial disk was picked from the colony’s edge and inoculated on autoclaved custard apples (Annona squamosa) (Cardoso et al. 2002). Pycnidia were observed over the surface of whole fruits after incubation for four weeks at 25°C. Conidiophores were olive-colored, unicellular, winding, and ellipsoid to obovoid, with rare spore production. Conidia were hyaline, ellipsoid to fusiform, 5.0 to 7.0 (avg. 6.3) μm in length and 1.8 to 2.5 (avg. 2.0) μm in width. No sexual structure was observed. DNA extraction was conducted from the hyphae grown on the PDA of five representative isolates using the PrepMan® Ultra Sample Preparation Reagent (Applied Biosystems, USA). The internal transcribed spacer (ITS) and translation elongation factor-1α (TEF-1α) regions were amplified using primers ITS5/ITS4 (White et al. 1990) and EF1-728F (Carbone and Kohn 1999) /EF-2 (O’Donnell et al. 1998), respectively. The PCR reaction was in a 25 μL mixture system, including 1 μL of DNA template, 0.5 μL of each primer (10 μM), 0.5 mL of Mytaq polymerase (Bioline, USA), 5 μL of MyTaq buffer, and 17.5 μL PCR grade water (Yin et al. 2020). PCR conditions were an initial denaturation step at 95°C for 3 min, followed by 35 cycles of 95°C for 30 s, 55-52°C for 30 s, and 72°C for 1 min, and a final elongation at 72°C for 10 min. The sequences obtained from this study were deposited in GenBank under the accession numbers OQ565301, OQ565302, OQ565303, OQ565304, OQ565305 (ITS), and OQ570636, OQ570637, OQ570638, OQ570639, OQ570640 (TEF-1α). The BLASTn results of ITS and TEF-1α sequences indicated that all isolates were 100% identical to Cophinforma tumefaciens isolate IMI 76762 (accession no. MW810287 and MZ073950, respectively). The combined ITS and TEF-1α dataset of Cophinforma and related genera obtained from Genbank was analyzed using the maximum likelihood method, applying the GTR+I+G model, with 1,000 bootstrap replications conducted in MEGA 11. Phylogenetic analysis confirmed the identification of these isolates as C. tumefaciens (Cardoso et al. 2019, Phillips et al. 2013, Zhao et al. 2021). Pathogenicity tests were conducted on fifty seedlings (two-year-old, 40 cm in height, 1.5-2 cm in diameter) with five representative isolates. Each isolate was used to inoculate ten seedlings. The stem surface was disinfected with 75% ethanol for 30 seconds, rinsed with sterilized water, and wound to remove part of the phloem. A 1 cm diameter mycelial plug was taken from the margin of a 14-day-old PDA plate and placed on the wound. The inoculated wounds were covered with sterile medical gauze to prevent desiccation and contamination. For comparison, control plants were inoculated with non-colonized PDA plugs. All the plants were incubated in field conditions. After four weeks, a raised mass appeared, and browning was observed at the inoculation site, whereas plants used as controls remained symptomless. The one-way ANOVA statistical analysis was conducted in the pathogenicity test. The average lesion lengths of the testing group were 16-24 cm, while the lesions in the control group showed almost no expansion during pathogenicity tests (P<0.05). The same fungus was reisolated from the lesions of inoculated plants, fulfilling Koch’s postulates. This is the first report of C. tumefaciens causing stem swelling, canker, and dieback of Ca. sinensis in China. The widespread nature of this disease and its potential impact on tea production underscore the need for further research into its outbreak mechanisms and effective control measures.

PMID:40517298 | DOI:10.1094/PDIS-05-24-0966-PDN

Neuro Oncol. 2025 Jun 15:noaf142. doi: 10.1093/neuonc/noaf142. Online ahead of print.

ABSTRACT

BACKGROUND: Years of Life Lost (YLL) is a disease burden measure quantifying the number of years lost due to premature mortality for a given disease. The present study sought to assess YLL for primary brain and other central nervous system (CNS) tumor histopathologies in the United States.

METHODS: Mortality, incidence, and life expectancy data for mortalities occurring in 2018 were obtained from the National Vital Statistics System and the National Program of Cancer Registries. Tumor specific YLL was estimated by subtracting age of death from projected life expectancy; mean YLL (mYLL) was determined to assess the impact of CNS tumor diagnosis on the individual patient level.

RESULTS: For mortalities occurring in 2018, the total YLL due to malignant CNS tumors was 364,223 years (mYLL = 21.2 years), compared to 15,472 years (mYLL = 14.2 years) for non-malignant tumors. Glioblastoma had the highest total YLL amongst malignant CNS tumors (58.8% of all primary CNS tumor YLL; mYLL = 19.8 years), and non-malignant meningioma amongst non-malignant CNS tumors (2.9% of all primary CNS tumor YLL; mYLL = 14.4 years). Malignant pediatric tumors had the greatest mYLL, with medulloblastoma having a mYLL of 61.2 years and other embryonal tumors a mYLL of 50.7.

CONCLUSIONS: Malignant CNS tumors, glioblastoma in particular, contributed the most to total YLL, whereas pediatric CNS malignancies had the greatest mYLL. Used with other epidemiological data, the authors contend that this quantification may help rationalize allocation of clinical and research resources.

PMID:40517297 | DOI:10.1093/neuonc/noaf142

Eur J Orthod. 2025 Jun 12;47(4):cjaf041. doi: 10.1093/ejo/cjaf041.

ABSTRACT

BACKGROUND: Adolescents undergoing orthodontic fixed appliance treatment face an increased risk of dental caries and developing white spot lesions (WSLs) due to challenges in maintaining effective oral hygiene. Preventive measures, including adherence to clinical guidelines, are important to reduce these risks.

OBJECTIVE: To analyse adherence to clinical practice guidelines (CPGs) amongst patients undergoing orthodontic treatment with buccal fixed appliances in the northeast of the Netherlands.

METHODS: A survey was presented to 539 adolescents aged 12-17 undergoing buccal fixed appliance treatment. Participants were recruited from ten orthodontic practices. The survey assessed adherence to the six recommendations of the Dutch CPGs. An adherence sum score (range 0 to 6) was calculated. Descriptive statistics and linear regression analyses (1000 bootstrap samples) were performed to analyse the relationships between participants’ characteristics and adherence sum scores.

RESULTS: In total, 485 adolescents started the survey, of whom 393 (72.9%) could be included (57% female; 48.9% aged 13 or 14). The median adherence sum score was 5 (IQR 4, 5), and 22.6% (n = 89) had an adherence sum score of 6. Males had a lower adherence sum score than females (-0.442, 95% CI: -0.979, -0.234). Older participants had a lower adherence sum score than younger participants (-0.066, 95%CI: -0.136, 0.002) per year of age. Higher educated participants had a lower adherence sum score than participants with lower education (-0.534, 95%CI: -0.953, -0.096).

LIMITATIONS: Self-reported data may introduce information bias as participants may give socially desirable answers.

CONCLUSIONS: Adherence to the CPGs amongst adolescents with buccal fixed orthodontic appliances is suboptimal, particularly in boys and older adolescents. Tailored educational interventions may address these gaps.

PMID:40517296 | DOI:10.1093/ejo/cjaf041

Biophys J. 2025 Jun 13:S0006-3495(25)00368-6. doi: 10.1016/j.bpj.2025.06.008. Online ahead of print.

ABSTRACT

Magnetotactic bacteria (MTB) are a diverse group of microorganisms whose movement can be directed via a magnetic field, which makes them attractive for applications in medicine and microfluidics. One of their key properties is the magnetic moment m, which is challenging to measure. We perform optical imaging experiments with MSR-1 MTB, and derive both the m statistics and the scaling of m with the MTB size using an explicit and fully automated method to determine m from the MTB trajectories via the U-turn protocol, which measures m based on the U-shaped trajectories exhibited by the MTB in an applied alternating magnetic field. The proposed method is an alternative to the standard U-turn time-based moment calculation and uses the theoretical U-turn shape function we have derived. This directly accounts for the U-turn geometry and determines the moment from the U-turn branch width. We couple this approach with a robust U-turn decomposition algorithm that detects U-turns from MTB tracks regardless of their orientations. We report a linear dependence of m on the size of the bacteria, accounting for the bacteria velocity variations during the U-turns. We also show that the new U-turn shape-based and the conventional time-based methods produce significantly different results. The proposed method can be used to differentiate between various types of MTB within the same population based on their velocity and magnetic moments, and to precisely characterize the magnetic properties of a culture.

PMID:40517290 | DOI:10.1016/j.bpj.2025.06.008

Sports Health. 2025 Jun 14:19417381251343085. doi: 10.1177/19417381251343085. Online ahead of print.

ABSTRACT

BACKGROUND: Limb dominance implies preferential or asymmetrical performance between limbs. There is currently no consensus regarding limb dominance definition for the lower extremity. Previous work described several methods of subjective reporting for lower extremity limb dominance; however, the correlation between objective performance and subjective perception of limb dominance is poorly understood, particularly among adolescent athletes. The purpose of this study was to test the agreement between objective performance and self-selected limb dominance in 3 different single-leg hopping tasks.

HYPOTHESIS: There will be a positive association between self-selected limb dominance and objective performance.

STUDY DESIGN: Cross-sectional cohort study.

LEVEL OF EVIDENCE: Level 3.

METHODS: Self-selected limb dominance was determined by asking, “Which leg would you use to kick a ball as far as you could?” Participants performed a series of single-leg hops, and 3-trial means of the single hop (SH), timed hop (TH), and vertical hop (VH) were used for analysis. Paired samples t test or Wilcoxon-signed rank test identified differences in limb performance for each hop test. Chi-square analysis evaluated associations between self-selected limb dominance and objective performance.

RESULTS: A total of 352 healthy youth athletes (55% male; mean age, 11.1 ± 1.7 years) participated. There was a small statistically significant difference between limbs on all hop tests. Chi-square analysis revealed no associations (P > 0.05) between self-selected limb dominance and objective performance across all hop test constructs.

CONCLUSION: A single limb performed better on all hop tests by a small and not clinically relevant difference. Perceived limb dominance did not predict performance regardless of hopping task.

CLINICAL RELEVANCE: Symmetrical performance on the SH, TH, and VH is normal in uninjured athletes. When returning injured athletes to sport, clinicians should aim for restoring hop test symmetry regardless of whether the injured limb is the perceived dominant limb.

PMID:40517289 | DOI:10.1177/19417381251343085