Nevin Manimala

Emerg Radiol. 2025 Apr 21. doi: 10.1007/s10140-025-02340-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study explored POCUS knowledge, attitudes, confidence, barriers, enablers, and their associated factors among radiologists and emergency physicians in Jordan.

METHODS: A cross-sectional questionnaire-based study covered five sections: socio-demographics, knowledge, attitude, confidence, and barriers and enablers. Summary statistics, correlation, and regression analyses were performed.

RESULTS: A total of 164 physicians participated, with an average age of 33.8 (± 7.69) years; 52.4% were radiologists and 47.6% were emergency physicians. Participants exhibited good knowledge, attitudes, and confidence. Higher attitude scores (β = 0.28; p < 0.001) and having a POCUS machine (β = 1.70; p = 0.01) were associated with higher knowledge. Higher knowledge (β = 0.64; p < 0.001) predicted better attitudes, while attitude (β = 0.21; p = 0.01), specialty radiologist (β = 8.5; p < 0.001), age (β = 0.23; p < 0.001), and number of monthly scans (β = 0.01; p = 0.01) predicted confidence.

CONCLUSION: Radiologists and emergency physicians in Jordan demonstrated good POCUS knowledge, attitudes, and confidence. Specialty and usage frequency influenced these factors. Future studies should explore training effects on skill acquisition. The study found different factors that are associated with knowledge, attitude, and confidence levels such as specialty, frequency of using POCUS, and the levels of knowledge, attitude and confidence. Future studies, including large prospective studies and/or experimental studies that examine the effect of training on skill acquisition among various healthcare professionals are warranted.

PMID:40254692 | DOI:10.1007/s10140-025-02340-7

Neurol Sci. 2025 Apr 21. doi: 10.1007/s10072-025-08183-x. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic unilateral vestibulopathy (CUVP) is one of the most common causes of chronic dizziness/vertigo. The brain functional mechanisms of CUVP are currently unclear. The study aimed to clarify changes in brain topological properties and subnetwork functional connectivity in CUVP patients, elucidating the neural mechanisms behind their poor dynamic compensation.

METHODS: A total of 44 participants were included (22 CUVP patients and 22 age- and sex-matched healthy controls). Resting-state functional MRI was performed on all subjects. Network-Based Statistics (NBS) analysis was conducted to identify abnormal neural circuits in CUVP. Graph-theoretical analysis (GTA) was performed to elucidate changes in brain network topological properties. Correlation analysis was conducted to examine the relationship between brain network changes and clinical symptom severity.

RESULTS: NBS analysis revealed an abnormal neural network in CUVP patients, with key nodes including the parieto-insular vestibular cortex, sensory-motor cortex, occipital visual cortex, brainstem, and cerebellum. The most significant functional connectivity abnormalities were observed between the brainstem and visual/sensorimotor networks. Graph-theoretical analysis indicated increased characteristic path length, decreased global and local efficiency in CUVP patients. Node properties showed reduced node efficiency and clustering coefficients in multiple nodes within the visual and sensorimotor networks. Correlation analysis indicated that brain network topology and changes in brainstem-sensorimotor network connectivity were negatively correlated with DHI scores.

CONCLUSION: CUVP patients exhibit multisensory integration abnormalities and changes in brain network topology at both the brainstem/cerebellar and cortical levels, which may underlie the potential neural basis for poor vestibular compensation in CUVP patients.

PMID:40254685 | DOI:10.1007/s10072-025-08183-x

Clin Exp Med. 2025 Apr 21;25(1):121. doi: 10.1007/s10238-025-01650-x.

ABSTRACT

This study aims to evaluate the utility of gastric ultrasound in assessing gastric emptying dysfunction in patients with hepatitis B cirrhosis and its correlation with alterations in portal venous flow and liver stiffness. Gastric motility and emptying parameters, portal venous flow parameters, and liver stiffness were measured by ultrasound in 42 patients with hepatitis B cirrhosis and 48 healthy controls. Statistical analysis was performed to compare the differences in these parameters between the two groups and to analyze the correlation between gastric ultrasound parameters and alternations in portal venous blood flow and liver stiffness. Firstly, the Gastric Motility Index was significantly lower in the experimental group than in the control group, while other gastric ultrasound parameters were significantly higher (p < 0.01). Secondly, measurements obtained from two-dimensional ultrasound, Color Doppler Flow Imaging, and two-dimensional Shear Wave Elastography revealed that Portal Vein Diameter (PVD) and Liver Stiffness (LS) were significantly higher in the experimental group compared to the control group, while the maximum portal vein velocity (PVmax) was significantly lower (p < 0.01). Finally, correlation analysis demonstrated that gastric ultrasound parameters correlated with PVD, PVmax, and LS. Gastric function is significantly impaired in patients with hepatitis B cirrhosis compared to controls, and gastric ultrasound parameters demonstrate a notable correlation with PVD, PVmax, and LS. Gastric ultrasound effectively evaluates gastric motility and emptying function in these patients, offering a reliable foundation for clinical diagnosis and management.

PMID:40254679 | DOI:10.1007/s10238-025-01650-x

Sci Rep. 2025 Apr 20;15(1):13632. doi: 10.1038/s41598-025-98517-8.

ABSTRACT

Testosterone deficiency seriously affects male reproductive function, growth and development, and quality of life. There is a certain association between inflammation and testosterone. PIV, a novel immune-inflammatory biomarker, has emerged. However, little is known about the relationship between PIV and serum testosterone. This study aims to investigate the relationship between PIV and serum testosterone. In this cross-sectional study, we analyzed data from 7389 participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Serum total testosterone levels were measured using precise isotope dilution liquid chromatography and tandem mass spectrometry. PIV was calculated as (neutrophil count × monocyte count × platelet count)/lymphocyte count. Weighted t tests or chi-square tests were utilized to analyze the basic characteristics of the population. Weighted logistic regression analysis, smooth-fit curves, threshold effects, and subgroup analysis were conducted to investigate the correlation between the PIV and testosterone deficiency. Using PIV Quartile 1 as the reference, in the fully adjusted model, the odds ratios (OR) and 95% confidence intervals (CI) for Quartile 2 to Quartile 4 participants were 1.14 (0.93, 1.40), 1.28 (0.99, 1.65), and 1.51 (1.18, 1.95), respectively (P for trend < 0.001), with participants in the highest quartile of PIV having a 51% increased risk of testosterone deficiency compared to those in the lowest quartile of PIV. Smooth-fit curves and threshold effect analysis revealed a nonlinear relationship between PIV and testosterone deficiency, with a turning point at 565.89. The subgroup analysis results showed that, except for obesity, there was no statistically significant difference in the relationship between PIV and testosterone deficiency among different subgroups (P > 0.05). Our study results indicate a positive correlation between PIV and the risk of testosterone deficiency. This suggests that PIV may serve as a potential indicator for testosterone deficiency.

PMID:40254668 | DOI:10.1038/s41598-025-98517-8

Neurol Ther. 2025 Apr 20. doi: 10.1007/s40120-025-00735-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Approximately 20% of patients with stroke are anemic, and previous studies have identified a U-shaped relationship between hemoglobin levels and all-cause mortality in stroke survivors. However, these studies have not specifically focused on patients with stroke taking antiplatelet agents. This study investigates the impact of anemia and hemoglobin (HGB) on mortality in this population.

METHODS: This study included 356 stroke survivors from the National Health and Nutrition Examination Survey 1999-2018 who were taking antiplatelet agents. It analyzed the impact of HGB levels and anemia on all-cause mortality using Cox regression, examined the nonlinear relationship between HGB and mortality through restricted cubic splines (RCS), and illustrated survival over time using Kaplan-Meier survival curves.

RESULTS: RCS analysis revealed no nonlinear relationship between HGB and all-cause mortality (P for overall < 0.01, P for nonlinear = 0.36), with lower HGB levels associated with an increased risk of all-cause mortality. Cox regression analysis showed that HGB was negatively associated with mortality risk across all models (Model 4: hazard ratio = 0.81, 95% confidence intervals 0.73-0.91, P < 0.01). Additionally, anemia significantly increased the risk of mortality in all models (Model 4: hazard ratio = 2.05, 95% confidence intervals 1.43-2.95, P < 0.01). Kaplan-Meier survival curves demonstrated that the survival rate in the anemic group was significantly lower than that of the non-anemic group (P < 0.01).

CONCLUSION: In stroke survivors taking antiplatelet agents, anemia is associated with an increased risk of all-cause mortality, while HGB levels are negatively correlated with mortality risk.

PMID:40254666 | DOI:10.1007/s40120-025-00735-9

Sci Rep. 2025 Apr 21;15(1):13657. doi: 10.1038/s41598-025-98111-y.

ABSTRACT

Accurate traffic sign recognition (TSR) is critical for enhancing the safety and reliability of autonomous driving systems. This study proposes an optimized YOLOv5-based framework to address challenges such as small-scale detection, environmental variability, and real-time processing constraints. Three key innovations are introduced: (1) k-means++ clustering for anchor box optimization, achieving a 77.55% average IoU (vs. 75.95% for traditional k-means) to enhance small-target detection; (2) comprehensive comparative analysis of YOLOv5 variants (s/m/x), revealing precision-speed trade-offs (99.3-99.5% mAP@0.5 vs. 32-45 ms inference time) for deployment flexibility; and (3) systematic hyperparameter tuning to maximize robustness across diverse scenarios. Leveraging the CCTSDB dataset (13,830 annotated images), experiments demonstrate the framework’s superiority: it attains 98.1% mean average precision (mAP), 98.6% recall, and 99.3% precision, outperforming Faster-RCNN and SSD by 5-8% in mAP while maintaining 45 FPS throughput. The YOLOv5s variant achieves optimal balance with 99.3% mAP@0.5 and 32 ms per-image inference, validated through rigorous statistical analysis (Tukey HSD). Robust performance in challenging conditions (e.g., small sample, backlit sample, foggy scenes) is evidenced by detection confidence exceeding 0.90. These results highlight the framework’s applicability in latency-sensitive intelligent transportation systems.

PMID:40254650 | DOI:10.1038/s41598-025-98111-y

Sci Rep. 2025 Apr 20;15(1):13631. doi: 10.1038/s41598-025-95699-z.

ABSTRACT

Tuberculosis (TB) is a significant global public health concern. The incidence of extrapulmonary tuberculosis (EPTB) is increasing; however, comprehensive data on its epidemiological and clinical characteristics remain limited, especially among populations who are co-infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). This study aimed to assess the incidence and predictors of EPTB in patients co-infected with HIV or HCV in Egypt. We conducted a retrospective cohort study on patients infected with TB who are treated in Egyptian chest hospitals from January 1 to December 31, 2023. Patients were categorized into pulmonary TB (PTB) and EPTB. Clinical data, including HIV or HCV co-infection status, were analyzed to identify risk factors and comorbidities associated with EPTB. Multilevel logistic regression was employed to examine predictors of EPTB. Among 7,245 TB patients, 42.5% were diagnosed with EPTB. Determinant of EPTB were HIV-positive (OR = 0.46, 95% CI: 0.30-0.71, p < 0.001), being male (OR = 0.31, 95% CI: 0.27-0.35, p < 0.001 ), age (particularly children under 5 years) (OR = 4.75, 95% CI: 2.29-9.84, p < 0.001 ), urban residency (OR = 1.05, 95% CI: 0.87-1.27, p < 0.05), and comorbidities (OR = 0.59, 95% CI: 0.35-0.98, p < 0.05). The most common sites for EPTB were the lymph nodes (27.10%) and pleural cavity/effusion (24.60%). EPTB represents a substantial proportion of TB cases in Egypt, particularly among younger individuals and females. Despite the low percentage of HIV or HCV co-infection in EPTB cases, further analysis and diagnostic testing of undiagnosed patients are required. These findings underscore the need for targeted interventions and comprehensive care models for TB patients, especially in the context of HIV co-infection.

PMID:40254648 | DOI:10.1038/s41598-025-95699-z

Curr Environ Health Rep. 2025 Apr 21;12(1):19. doi: 10.1007/s40572-024-00469-0.

ABSTRACT

PURPOSE OF REVIEW: Studies examining the effects of social factors on the epigenome have proliferated over the last two decades. Social epigenetics research to date has broadly demonstrated that social factors spanning childhood adversity, to neighborhood disadvantage, educational attainment, and economic instability are associated with alterations to DNA methylation that may have a functional impact on health. These relationships are particularly relevant to brain-based health outcomes such as psychiatric disorders, which are strongly influenced by social exposures and are also the leading cause of disability worldwide. However, social epigenetics studies are limited by the many challenges faced by both epigenome-wide association studies (EWAS) and the study of social factors.

FINDINGS: In this manuscript, we provide a framework to achieve greater rigor and reproducibility in social epigenetics research. We discuss current limitations of the social epigenetics field, as well as existing and new solutions to improve rigor and reproducibility. Readers will gain a better understanding of the current considerations and processes that could maximize rigor when conducting social epigenetics research, as well as the technologies and approaches that merit attention and investment to propel continued discovery into the future.

PMID:40254641 | DOI:10.1007/s40572-024-00469-0

Nat Commun. 2025 Apr 20;16(1):3737. doi: 10.1038/s41467-025-58875-3.

ABSTRACT

Breast and cervical cancers are important causes of disability and premature death among women in Sub-Saharan Africa. Previous research has linked girls’ education to cancer service access. Here, we examine the causal effect of girls’ educational attainment on cancer screening practices by means of a natural experiment in Lesotho. In particular, we exploit variation in educational attainment among women that was introduced by an educational policy (a school-entry age cut-off). Data on awareness towards breast cancer, knowledge of Pap smear, breast self-exam, breast clinical exam, and having received a Pap smear is extracted from the Lesotho Demographic and Health Surveys 2009-10 and 2014 (N = 7971). Each additional year of schooling caused by the education policy increases awareness of breast cancer by 4.7 percentage points (p = 0.014, 95% Confidence Interval [CI]: 1.0, 8.5), awareness of Pap smear by 5.9 percentage points (p = 0.001, 95% CI: 2.3, 9.5), and engagement in Pap smear by 3.5 percentage points (p = 0.004, 95% CI: 1.1, 5.8). We found no statistically significant effects on breast self-exam and breast clinical exam.

PMID:40254639 | DOI:10.1038/s41467-025-58875-3

Sci Rep. 2025 Apr 20;15(1):13644. doi: 10.1038/s41598-025-97703-y.

ABSTRACT

Susceptibility of bats to white-nose syndrome (WNS), a lethal disease caused by the fungus Pseudogymnoascus destructans (Pd), may be influenced by the amount of activity outside hibernacula during the winter. We tested the effects of hibernaculum type (aboveground or subterranean) and Pd status (positive or negative) on winter activity of tricolored bats (Perimyotis subflavus) in the southeastern USA along with the effects of ambient temperature, precipitation, and stage of hibernation. We placed acoustic detectors at the entrances of 13 hibernacula (4 aboveground and Pd-positive, 4 aboveground and Pd-negative, 4 subterranean and Pd-positive, and 1 subterranean and Pd-negative) during winter 2020-21 and 2021-22. While neither hibernaculum type nor Pd status alone predicted probability of activity or levels of activity, these factors interacted with temperature, precipitation, and stage of the hibernation period. Activity increased at a greater rate with temperature and time since the onset of hibernation in aboveground and Pd-negative sites and decreased at a faster rate in response to precipitation. Our results suggest that tricolored bats using aboveground hibernacula such as culverts or bridges may be less susceptible to WNS due to greater nighttime activity. However, use of these structures may have other costs such as higher freezing and predation risks.

PMID:40254625 | DOI:10.1038/s41598-025-97703-y