Nevin Manimala

J Hazard Mater. 2025 Jun 10;495:138894. doi: 10.1016/j.jhazmat.2025.138894. Online ahead of print.

ABSTRACT

Large-scale mining and smelting activities have led to widespread heavy metal contamination in mining cities, with atmospheric dust serving as a key carrier. However, identifying and quantifying metal sources remain challenging due to overlapping pollution sources. This study analyzed heavy metal concentrations, ecological risks, and Cd isotopes in atmospheric road dust from Panzhihua, a major mining city in Southwest China. The results indicate that mining-related metals (V, Cr, Mn, Ni, Co) showed low exceedance rates and ecological risks. In contrast, Cd, a dispersed element in V-Ti magnetite, significantly exceeded background levels and posed the highest risk. The PCA and PMF were first used to constrain potential source categories, followed by Cd isotope analysis for precise quantification. The results revealed vehicular emissions (45 %), coal combustion (29 %), and smelting (26 %) as major Cd sources. Smelting contributions were higher in downwind residential areas (1.5-5 km) due to prevailing southwest winds and thermal uplift. These findings highlight the unexpected dominance of traffic emissions over industrial sources and provide location-specific insights for pollution control. The study underscores the need to address both industrial and non-industrial sources when managing metal pollution in mining cities and offers a transferable approach for complex urban settings.

PMID:40513162 | DOI:10.1016/j.jhazmat.2025.138894

Public Health. 2025 Jun 12;246:105798. doi: 10.1016/j.puhe.2025.105798. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate smoking patterns and their relationship with uncontrolled blood pressure in Iranian adults with hypertension.

STUDY DESIGN: A cross-sectional study was conducted to explore the research objectives.

METHODS: This study used data from the 2021 national Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS) survey, which employed a clustered sampling technique to recruit Iranian adults aged ≥18 years from urban and rural areas across 31 provinces. Hypertension was defined as a systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, a history of hypertension diagnosis or use of antihypertensive medication. Smoking behaviours, including cigarette and hookah use, were assessed using the STEPS questionnaire. Data on sociodemographic variables, physical activity (min/weeks) and comorbidities were also collected. This study used t-tests and chi-square tests, as well as multivariable regression models adjusting for covariates, to examine the relationship between smoking status and blood pressure.

RESULTS: Among 27,874 participants, 8883 with hypertension were included in the analysis. The weighted prevalence of uncontrolled hypertension was 71.25 %. Smoking patterns revealed that 58.75 % were never smokers, 3.47 % were ex-smokers, 12.13 % were current smokers and 25.65 % were passive smokers. Current smokers had a higher prevalence of controlled hypertension (31.43 %) compared to ex-smokers (26.05 %), but the differences were not statistically significant (p = 0.225). Current smokers had 44 % lower odds of being ≥60 years (versus 18-39-year-olds) and were 8.32 times more likely to be male than female. Higher body mass index (BMI) and a higher wealth index were each associated with reduced odds of smoking, whereas alcohol consumption was linked to increased odds. Current smoking was associated with a 0.24 mmHg increase in SBP and a 0.35 mmHg decrease in DBP, but these associations were not statistically significant.

CONCLUSIONS: This study revealed a high prevalence of smoking among hypertensive individuals, especially among younger males, those with lower BMI and alcohol users. These findings underscore the need for culturally tailored smoking cessation programmes and longitudinal research to clarify the causal pathways of tobacco use in this high-risk group.

PMID:40513154 | DOI:10.1016/j.puhe.2025.105798

J Infect Dis. 2025 Jun 13:jiaf321. doi: 10.1093/infdis/jiaf321. Online ahead of print.

ABSTRACT

No large studies have evaluated whether the human oral microbiome is directly associated with mortality. We evaluated prospective associations between the oral microbiome, measured using 16S rRNA gene sequencing, from participants aged 20-69 years in the 2009-2012 cycles of the National Health and Nutrition Examination Survey (NHANES) and all-cause mortality (N=7,721, representing ∼194 million individuals). Alpha diversity was inversely associated with mortality, and some significant associations were observed with the beta diversity matrices. Higher relative abundances of Granulicatella and Lactobacillus were associated with increased risk, while Bacteroides was associated with decreased all-cause mortality at the genus level. Results suggest oral bacterial communities may be important contributors to health and disease.

PMID:40513117 | DOI:10.1093/infdis/jiaf321

JMIR Mhealth Uhealth. 2025 Jun 13;13:e60569. doi: 10.2196/60569.

ABSTRACT

BACKGROUND: Monitoring hydration is crucial for maintaining health and preventing dehydration. Despite the potential of wearable devices for continuous hydration monitoring, health research hasn’t fully explored this application, and clear design guidelines are absent. This scoping review aimed to address this gap by analyzing current research trends and assessing the potential impact of wearable technologies for hydration monitoring.

OBJECTIVE: This review comprehensively examined recent advancements in wearable hydration-monitoring technologies, focusing on their capabilities, limitations, and research and prototype designs. It explored various sensors and technologies used to track hydration, compared their advantages and disadvantages, identified trends in wearable hydration-monitoring devices, evaluated their accuracy and reliability against established benchmarks, and reviewed commercially available products to bridge research findings and practical applications.

METHODS: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we systematically searched PubMed, IEEE Xplore, and Google Scholar for studies (2014-2024) on noninvasive wearable devices that used physiological biomarkers. Validation with human participants or comparisons with gold standards was required. Data extraction covered study characteristics, sensor technologies, validation methods, and commercial product analysis. In addition to academic research papers, gray literature was included through a Google Scholar search to investigate commercial products in the field of hydration monitoring. This approach ensured a broader perspective on technological advancements and market trends.

RESULTS: The review synthesized 63 articles selected from 156 included for full-text analysis. The literature was categorized based on sensor types, including electrical, optical, thermal, microwave, and multimodal sensors. Most studies (47/63, 75%) examined the effects of hydration on physiological parameters, with some (16/63, 25%) focusing on hydration status during physical activity or in specific environmental conditions. Commercially available products from 8 companies were also evaluated for their technological features, functionalities, and applications. The dominance of electrical sensors in research was highlighted due to their ease of use and integration into wearable devices. While fewer in number, optical sensors demonstrated higher precision and provided molecular-level insights. The emergence of multimodal sensors suggests a trend toward combining technologies to improve accuracy, as reflected by their increasing publication share. Other sensors, such as thermal and microwave-based sensors, occupied specialized niches. The growing acceptance of optical-based wearables in the market reflects their cost-to-precision effectiveness.

CONCLUSIONS: Wearable hydration-monitoring devices provide real-time assessments of hydration status, but challenges remain in ensuring their reliability, accuracy, and applicability across diverse populations and conditions. Future directions for research include standardized protocols, extensive clinical trials, sensor miniaturization, and enhanced wearability. Multimodal systems that integrate various sensors with artificial intelligence-driven analysis hold promise for personalized hydration management. This review offers detailed insights into the strengths and challenges of sensor technologies, paving the way for practical skin hydration-monitoring solutions.

PMID:40513095 | DOI:10.2196/60569

JMIR Hum Factors. 2025 Jun 13;12:e60628. doi: 10.2196/60628.

ABSTRACT

BACKGROUND: Anxiety and depression symptoms have been rising among college students, with many increasingly meeting the criteria for 1 or more mental health problems. Due to a rise in internet access and lockdown restrictions associated with the COVID-19 pandemic, online mediums, such as teletherapy, repositories for mental health information, discussion forums, self-help programs, and online screening tools, have become more popular and used by college students to support their mental health. However, there is limited information about individual-level factors that lead college students to use these online tools to support their mental health.

OBJECTIVE: This mixed methods study aimed to examine the associations between demographics, symptom severity, mental health literacy, stigma, attitudes, and self-efficacy and the use of online tools to seek psychological information and services among racially and ethnically diverse college students. This study also aimed to qualitatively characterize types of online tools used, reasons for using tools or lack thereof, and perceived helpfulness of tools.

METHODS: Undergraduate students (N=123) completed validated measures and provided open-ended descriptions of the types of online tools they used to seek psychological information and services and their reasons for using those tools. Logistic regression analyses were used to test associations of online tool use to seek mental health information and hypothesized predictors. Descriptive statistics were conducted to examine online tool types, reasons for using online tools, and helpfulness explanations.

RESULTS: In total, 49.6% (61/123) of the participants used online tools (eg, search engines) to seek mental health information, while 30.1% (37/123) used online tools (eg, medical websites) to seek mental health services. Mental health literacy (P=.002; odds ratio 1.14, 95% CI 1.05-1.24) was associated with greater use of online tools to seek mental health information. None of the hypothesized variables predicted online tool use to seek mental health services. In total, 82% (50/61) of participants who sought information found online tools somewhat helpful, while 49% (18/37) of participants who sought services found online tools very helpful. Of the students who did not use online tools to seek information, 19% (12/62) reported it was because they did not know which online tools to use and 31% (19/62) stated they would be encouraged to use online tools if it was recommended by professionals, therapists, family, or friends. Of the students who did not use online tools to seek services, 33% (28/86) reported it was because they did not think mental health help was necessary.

CONCLUSIONS: These findings highlight the use of online tools to provide mental health information and connect to professional services, suggesting that online tools are widely used to access mental health support.

PMID:40513094 | DOI:10.2196/60628

Nano Lett. 2025 Jun 13. doi: 10.1021/acs.nanolett.5c02087. Online ahead of print.

ABSTRACT

Single-particle electrochemistry (SPE) is essential for uncovering the electrochemical behavior and underlying mechanisms of individual nanomaterials. However, conventional approaches often overlook dynamic interactions between nanocrystals and the conductive substrate, leading to significant interference from substrate-induced concentration gradients and electron-transfer perturbations. Here, we address this challenge by developing transient electrogenerated chemiluminescence microscopy (ECLM) to visualize the diffusion dynamics and electrocatalytic behavior of single PtAu-loaded carbon nanoparticles. ECL imaging quantitatively analyzes reaction kinetics at single nanocatalysts and reveals the diffusion dynamics significantly influenced by conductive substrate. To mitigate substrate-induced interference and improve measurement accuracy, we introduce the pulse-clean cycle technique (PCCT). By applying millisecond-level potential pulses, PCCT achieves high temporal resolution and captures rapid catalytic events with statistical reliability. This work bridges the gap between single-particle imaging and precise kinetic quantification, offering a robust platform for probing nanoscale electrocatalytic transients, understanding nanostructure-activity relationships, and guiding the rational design of advanced nanocatalysts.

PMID:40513079 | DOI:10.1021/acs.nanolett.5c02087

Neurology. 2025 Jul;105(1):e213795. doi: 10.1212/WNL.0000000000213795. Epub 2025 Jun 13.

ABSTRACT

BACKGROUND AND OBJECTIVES: The aim of this study was to gain rare insight into prolonged cluster headache (CH) remission by (1) identifying patterns and factors associated with and (2) phenotypical changes before prolonged remission. The results can help patients better understand their disease course and uncover mechanisms behind spontaneous remission.

METHODS: In this cross-sectional cohort study, all participants with a history of (probable) CH from the Leiden University Medical Center cohort were invited to complete a screening survey. Participants in prolonged remission were invited for a telephone interview. Prolonged remission was defined as (1) no current prophylactic treatment and (2) an attack-free period of ≥5 years and/or twice the mean between-episode time. Main outcomes are average age at prolonged remission onset and disease duration. Data were collected between April 10 and August 9, 2024, and analyzed using descriptive and survival statistics.

RESULTS: Of those invited, 43.2% (778/1,801) responded; 625 were included in the survey analysis, and 125 (20%) met prolonged remission criteria during interview. The median age at inclusion was 58 years (interquartile range [IQR] 48-67) with 32% female. Remission occurred on average at age 55 (IQR 48-63) after a disease duration of 23 (15-33) years. In 62% (N = 78), remission occurred abruptly. Of those with gradual remission (38%, N = 47), attack frequency (65%) and intensity (59%) decreased and between-episode intervals increased (52%) before remission. Probability of prolonged remission was higher in those with episodic CH (hazard ratio [HR] 6.60, 95% CI 3.55-12.31), who had quit smoking (HR 2.53, 95% CI 1.66-3.86), who had a higher attack intensity (HR 1.28, 95% CI 1.08-1.52), and who had a higher age at disease onset (HR 1.05, 95% CI 1.03-1.06).

DISCUSSION: This cohort offers rare insight into prolonged CH remission, typically starting around the mid-50s after 25 years of active disease. Prolonged remission is not tied to a single factor such as disease duration. Remission onset does not peak at a specific age, and disease duration varies widely between patients with remission. Remission probability is higher in the episodic form despite a longer disease duration compared with the chronic form. The association between quitting smoking and prolonged remission supports a causal link with smoking and disease activity. These preliminary retrospective results require confirmation in future studies.

PMID:40513059 | DOI:10.1212/WNL.0000000000213795

Neurology. 2025 Jul;105(1):e213589. doi: 10.1212/WNL.0000000000213589. Epub 2025 Jun 13.

ABSTRACT

BACKGROUND AND OBJECTIVES: N-acetyl-l-leucine (NALL) has been established to improve the neurologic manifestations of Niemann-Pick disease type C (NPC) after 12 weeks in a placebo-controlled trial. In the open-label extension phase (EP) follow-up, data were obtained after 12 and 18 months to evaluate the long-term effects of NALL for NPC.

METHODS: This is an ongoing, multinational, multicenter EP. Patients with a genetic diagnosis of NPC aged 4 years or older who completed the placebo-controlled trial were eligible to continue in the EP and receive orally administered NALL 2-3 times per day in 3 tiers of weight-based dosing. The primary end point is the modified 5-domain NPC Clinical Severity Scale (NPC-CSS) (range 0-25 points; lower score representing better neurologic status); data from the EP cohort are compared with the expected annual trajectory of decline (i.e., disease progression) established in natural history studies. Analyses are also performed on exploratory end points, including the 15-domain and 4-domain NPC-CSSs and the Scale for Assessment and Rating of Ataxia (SARA).

RESULTS: Fifty-three patients aged 5-67 years (45.3% female, 54.7% male) were enrolled in the EP. After 12 months, the mean (±SD) change from baseline on the 5-domain NPC-CSS was -0.27 (±2.42) with NALL vs +1.5 (±3.16) in the historical cohort (95% CI -3.05 to -0.48; p = 0.009), corresponding to a 118% reduction in annual disease progression. After 18 months, the mean (±SD) change was +0.05 (±2.95) with NALL vs +2.25 (±4.74) in the historical cohort (95% CI -4.06 to -0.35; p = 0.023). The 15-domain and 4-domain NPC-CSSs were consistent with the 5-domain NPC-CSS. The improvements in neurologic manifestations demonstrated in the placebo-controlled trial on the primary SARA end point were sustained over the long-term follow-up. NALL was well tolerated, and no treatment-related adverse events or serious reactions occurred.

DISCUSSION: Treatment with NALL was associated with a significant reduction in NPC disease progression after 12 and 18 months, demonstrating a disease-modifying, neuroprotective effect.

TRIAL REGISTRATION INFORMATION: The trial is registered with ClinicalTrials.gov (NCT05163288; registered December 6, 2021), EudraCT (2021-005356-10). The first patient was enrolled into the EP on March 8, 2023. The trial was funded by IntraBio Inc.

CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that NALL reduces disease progression in NPC.

PMID:40513057 | DOI:10.1212/WNL.0000000000213589

Neurology. 2025 Jul;105(1):e213615. doi: 10.1212/WNL.0000000000213615. Epub 2025 Jun 13.

ABSTRACT

BACKGROUND AND OBJECTIVES: Socioeconomically deprived neighborhoods are known to have higher incidence rates of stroke and less access to high-quality stroke care. We aimed to examine whether there is an association between neighborhood socioeconomic status (nSES) and functional outcome after endovascular thrombectomy (EVT) for ischemic stroke in a high-income country.

METHODS: Data from 2 randomized trials, which included patients treated with EVT within 6 hours after stroke onset: MR CLEAN-MED and MR CLEAN-NO IV were studied. A per postcode composite score of education, employment, and household income (scores ranging from -1 to 1) created by Statistics Netherlands, represented nSES. The association with functional outcome after 90 days (modified Rankin Scale [mRS]), functional independence (mRS 0-2), neurologic deficit at 24 hours (NIH Stroke Scale [NIHSS]), and radiologic outcomes (expanded treatment in cerebral infarction score and follow-up infarct volume [FIV]) were analyzed using regression analyses adjusted for patient characteristics, including baseline NIHSS.

RESULTS: We included 910 patients (median age 71.5 years, 404 (44.4%) women, median baseline NIHSS 15) in the analyses. Patients with a higher nSES had a higher likelihood of a more favorable functional outcome (a shift toward improved outcome on the mRS) (adjusted common odds ratio [OR] 1.90, 95% CI 1.21-3.01) and were more likely to have regained functional independence (adjusted OR 3.21, 95% CI 1.82-5.70) at 90 days. There was no significant association between the nSES and the degree of neurologic deficit at 24 hours (adjusted β -0.24, 95% CI -0.50 to 0.01, p = 0.06) or radiologic outcomes (reperfusion status [adjusted OR 0.89, 95% CI 0.45-1.78], FIV [adjusted β 0.01, 95% CI -0.17 to 0.20, p = 0.89]).

DISCUSSION: Living in a more socioeconomically affluent neighborhood was associated with a more favorable functional outcome at 90 days, but not with degree of neurologic deficit at 24 hours or radiologic outcomes. This suggests that nSES-based inequalities exist in the postacute phase of stroke care, and highlights the importance of continuing to work toward health equity for patients with stroke.

PMID:40513055 | DOI:10.1212/WNL.0000000000213615

Epidemiology. 2025 Jun 13. doi: 10.1097/EDE.0000000000001884. Online ahead of print.

ABSTRACT

Unmeasured confounding is a major concern in obtaining credible inferences about causal effects from observational data. Proximal causal inference is an emerging methodological framework to detect and potentially account for confounding bias by carefully leveraging a pair of negative control exposure and outcome variables, also known as treatment and outcome confounding proxies. Although regression-based proximal causal inference is well-developed for binary and continuous outcomes, analogous proximal causal inference regression methods for right-censored time-to-event outcomes are currently lacking. In this paper, we propose a novel two-stage regression proximal causal inference approach for right-censored survival data under an additive hazard structural model. We provide theoretical justification for the proposed approach tailored to different types of negative control outcomes, including continuous, count, and right-censored time-to-event variables. We illustrate the approach with an evaluation of the effectiveness of right heart catheterization among critically ill patients using data from the SUPPORT study. Our method is implemented in the open-access R package “pci2s.”

PMID:40513053 | DOI:10.1097/EDE.0000000000001884