Nevin Manimala

Sci Rep. 2025 Apr 19;15(1):13529. doi: 10.1038/s41598-025-90228-4.

ABSTRACT

Recently, superpixel segmentation has been widely employed in hyperspectral image (HSI) classification of remote sensing. However, the structures of land-covers in HSI commonly vary greatly, which makes it difficult to fully fit the boundaries of land-covers by single-scale superpixel segmentation. Moreover, the shape-irregularity of superpixel brings challenge for depth feature extraction. To overcome these issues, a multiscale superpixel depth feature extraction (MSDFE) method is proposed for HSI classification in this article, which effectively explores and integrates the spatial-spectral information of land-covers by adopting multiscale superpixel segmentation, constructing statistical features of superpixel, and conducting depth feature extraction. Specifically, to exploit rich spatial information of HSI, multiscale superpixel segmentation is firstly applied on the HSI. Once superpixels on different scales are obtained, two-dimensional statistical features with a united form are constructed for these superpixels with different spatial shapes. Based on these two-dimensional statistical features, a convolutional neural network is utilized to learn deeper features and classify these depth features. Finally, an adaptive strategy is adopted to fuse the multiscale classification results. Experiments on three real hyperspectral datasets indicate the superiority of the proposed MSDFE method over several state-of-the-art methods.

PMID:40253388 | DOI:10.1038/s41598-025-90228-4

J Health Popul Nutr. 2025 Apr 19;44(1):126. doi: 10.1186/s41043-025-00877-4.

ABSTRACT

BACKGROUND: Stillborn babies are those that are born with no signs of life at or after 28 weeks of gestation or weighing more than 1000 g. It is a public health problem that is overlooked in the global agenda. Individual studies have been conducted with different estimates across countries, making it difficult to understand the national stillbirth rate. Thus, this study aims to better understand stillbirth in Ethiopia and inform policy makers by producing pooled estimates.

METHODS: A systematic review and meta-analysis were performed between 2013 and 2024 in accordance with the PRISMA guidelines. The outcomes of interest in the English language were exhaustively searched in different databases, such as PubMed/Medline, Science Direct, HINARI and Google Scholar. Data selection, extraction and quality assessment were performed by two authors independently. Zotero was used for study selection, whereas all the statistical analyses were performed with MEDCALC version 23.2.1 software.

RESULT: Among a total of 1007 studies found in databases and manual citation searches, 35 studies were included in the analysis. The overall pooled stillbirth rate was 68 (95% confidence interval (CI) 52-85) per 1000 births in Ethiopia. Subgroup analysis revealed discrepancies in rates across regions, study years and settings. Subgroup analysis revealed that the pooled estimate of the stillbirth rate of recent studies (2021-2024) is 72 (95% CI, 48-100) per 1000 births, which is higher than the rate of earlier studies (2013-2020), with a rate of 63 (95% CI, 38-93) per 1000 births.

CONCLUSION: The pooled estimate of the stillbirth rate is high in Ethiopia compared with the global target stillbirth rate of 12 per 1000 births, which is set for 2030 and is also higher than African countries. The stillbirth rate has also increased over time in Ethiopia. This might be due to poor maternal health access and utilization, including a significant rate of iodine deficiency, among pregnant women in Ethiopia. The review informs policy makers and program implementers about the burden of stillbirth in Ethiopia. All health sector actors should adjust and improve the quality of maternal health services, with attention given to stillbirth to reach the global target.

PMID:40253383 | DOI:10.1186/s41043-025-00877-4

J Health Popul Nutr. 2025 Apr 19;44(1):125. doi: 10.1186/s41043-025-00814-5.

ABSTRACT

BACKGROUND: Despite improvements in child health and nutrition in Ethiopia, undernutrition remains a critical issue, causing half of child deaths. Many severely malnourished children seek treatment at therapeutic feeding centers, but a significant number still die in stabilization centers. This study aimed to estimate survival rates and identify predictors of mortality among children with severe acute malnutrition admitted to public health facilities in Hawassa City, Southern Ethiopia.

OBJECTIVE: The main aim of this study was to estimate survival status and predictors of mortality among children with severe acute malnutrition admitted to public health facilities at Hawassa City, Southern Ethiopia.

METHOD: A facility-based retrospective cohort study was employed to estimate survival status and predictors among under-five children with severe acute malnutrition admitted to selected health facilities. A total of 476 randomly selected under-five children with SAM from January 2018 to December 31, 2021, participated in the study. Data were analyzed by SPSS IBM version 26. Bivariable and multivariable Cox regression models assessed risk factors. Kaplan- Maier Curve and Long rank test were used to estimate cumulative survival probability and to compare survival status probability across different groups.

RESULTS: Over the 3-year observation period, the overall survival status was, (84.7%), [95% CI; 81.2, 87.8]. The incidence density of death was 3.8/100 person-day. The overall median survival time was 34 [95% CI 32.2-37.5] days. After controlling for other factors, a child who had co-morbidities [AHR = 3.305, 95%; CI: (1.1, 10.9)], and Albendazole [AHR = 5.3, 95%; CI: (1.3, 21.7)] were identified as the independent predictors of the time to death.

CONCLUSION: The findings of this study confirm the mortality rate was higher than in most national studies. A significantly low recovery rate was identified for the children with co-morbidities and those who had not been dewormed. Expanding the immunization programs and deworming programs regularly which link nutrition interventions was recommended to raise the recovery rate.

PMID:40253378 | DOI:10.1186/s41043-025-00814-5

Virol J. 2025 Apr 19;22(1):109. doi: 10.1186/s12985-025-02731-9.

ABSTRACT

BACKGROUND: Recent researches indicated a down-regulation of Human beta-defensin2 (HBD2) expression in cervical cancer cells, but the mechanism and clinical significance is not clear yet.

METHODS: In this paper, based on the data from the TCGA database, the bioinformatics analysis provided by the UALCAN server was used. The HBD2 mRNA levels were tested with RT-qPCR in cells and protein concentration in cell cultural supernatant was assayed with ELISA. When the gene of Human papillomavirus type 16 E7 oncoprotein (HPV16 E7) overexpression or knockdown, the protein expression of ASK1 and p38 MAPK was detected by Western blot.

RESULTS: The bioinformatics analysis results implied that mRNA levels of HBD2 in cervical cancer were lower obviously than healthy people. HBD2 mRNA levels and protein in CaSki and SiHa cells increased obviously under the condition of HPV16 E7 gene silence. However, HBD2 mRNA and protein levels decreased significantly in C33A and CaCo2 cells not only under the conditions of treatment with HPV16 E7 gene overexpression, but also the inhibition of ASK1-p38 MAPK pathway by SB-203580 or GS-4997, or shRNA expression plasmid of ASK1 transefction. Moreover, p-ASK1(Thr845), the activity forming protein of ASK1, and p-p38, decreased in C33A and CaCo2 cells accompanied with HPV16 E7 overexpression, while p-ASK1(Ser966) protein, an inhibitory forming protein kept in a same stable levels. The completely opposite patterns of the protein expression in ASK1-p38 MAPK pathway were obtained in CaSki and SiHa cells transfected with HPV16 E7 siRNA sequence. Interestingly, statistical higher levels of phosphorylated p38 and cellular apoptosis rates, were found in SiHa cells exposed in Anisomycin than in DMSO solution. And increased HBD2 protein concentration in cell cultural supernatant and decreased cell survial rates, were confirmed in CaSki and SiHa cells treatment with Anisomycin, at the same time.

CONCLUSIONS: Our results implied that HPV16 E7 suppresses HBD2 expression via the inhibition of the ASK1-p38 MAPK signaling pathway, and this mechanism might be a key way of anti-tumor effect of Anisomycin. This study provided a novel insight into the expression and regulation mechanism of HBD2 in tumors and offered a possible therapeutic strategy by using defensins for cervical cancer in future.

PMID:40253372 | DOI:10.1186/s12985-025-02731-9

Orphanet J Rare Dis. 2025 Apr 18;20(1):188. doi: 10.1186/s13023-025-03722-3.

ABSTRACT

BACKGROUND: Primary hypertrophic osteoarthropathy (PHO) is a rare genetic disorder classified into clinical subtypes and genetic subtypes. Previous clinical studies have primarily focused on case reports and family analyses, largely characterizing the genetic subtypes. However, there remains a long-standing gap in understanding the characteristics of the different clinical subtypes of PHO. This study aimed to determine the distribution of the three clinical subtypes of PHO and compare their clinical characteristics using a large global sample.

METHODS: A systematic literature search was conducted in multiple databases to categorize cases into complete form (CO), incomplete form (IN), and fruste form (FR). Statistical analyses were performed to assess clinical differences in a retrospective study design.

RESULTS: Males predominated across all subtypes, whereas females were most prevalent in IN patients (51.1%). IN patients had the highest family history rate (62.1%). Age at onset peaked in adolescence for CO and FR patients, while IN patients exhibited bimodal peaks in early childhood and adolescence. Congenital diseases were more frequent in IN patients (7.8%, P = 0.021), while CO patients had a higher prevalence of digestive system diseases (12.2%, P = 0.007). Urinary prostaglandin E2 (PGE2) and PGE Metabolite (PGEM) were consistently elevated in CO and FR patients. In IN patients, urinary PGE2 levels were also increased, but the urinary PGEM levels showed equal proportions of elevation and reduction. Genetic analysis revealed that solute carrier organic anion transporter family member 2A1 (SLCO2A1) mutations were predominant in CO (95 cases, 73.1%) and FR (22 cases, 57.9%) patients, whereas hydroxyprostaglandin dehydrogenase (HPGD) mutations were most frequently associated with IN (25 cases, 73.5%).

CONCLUSIONS: The three clinical subtypes of PHO exhibited distinct characteristics with no clear correlation between clinical and genetic subtypes. These findings highlighted the clinical significance of PHO typing and provided valuable insights for diagnosis, differential diagnosis and subtype-specific management strategies.

PMID:40251683 | DOI:10.1186/s13023-025-03722-3

J Orthop Surg Res. 2025 Apr 19;20(1):391. doi: 10.1186/s13018-025-05803-2.

ABSTRACT

PURPOSE: The dynamic hip screw (DHS) is a widely used method for hip fracture stabilisation, but conventional DHS (CHDS) fixations may be limited by longer surgical duration and delayed recovery compared to minimally invasive DHS (MIDHS) fixations. We describe a novel low-cost surgical method that reduces intraoperative time, peri-operative complications, and improves overall patient outcomes.

METHODS: A prospective double-blinded study included 15 patients who underwent surgical fixation of IT hip fractures using a 4-hole DHS system. All surgeries were performed at a tertiary referral hospital between January 2019 and April 2023 by surgeons with similar levels of experience. Main outcome measurements included tip-apex distance (TAD), surgery duration, haemoglobin loss, and hospital stay duration. Two independent assessors measured TAD using the post-operative anteroposterior and lateral radiographs. Kyle’s classification was used to categorize the IT fractures. IBM SPSS Statistics 26.0 for Mac (SPSS, Chicago, IL, USA) was used for the statistical analysis. Statistically significant difference was defined as p-value < 0.05.

RESULTS: Both groups had similar baseline characteristics (p > 0.05). Both groups had similar complexity in fractures, but the mean surgical duration was significantly shorter (p = 0.019) (43.8 ± 12.3 min) compared to the CDHS group (73.4 ± 18.2 min). Postoperatively, there was no significant difference (p > 0.05) in hospital stay duration, haemoglobin (Hb) loss, or TAD.

CONCLUSIONS: MIDHS group had shorter surgical duration compared to CDHS group, with no significant difference in TAD, haemoglobin loss and hospital stay duration.

PMID:40251666 | DOI:10.1186/s13018-025-05803-2

Cardiovasc Diabetol. 2025 Apr 18;24(1):172. doi: 10.1186/s12933-025-02717-5.

ABSTRACT

BACKGROUND: Type 2 diabetes is a stronger risk factor for cardiovascular disease (CVD) in women compared with men possibly due to higher susceptibility to develop myocardial microvascular dysfunction. We investigated sex-dependent effects of risk factors on myocardial blood flow (MBF) and myocardial flow reserve (MFR) in individuals with type 2 diabetes without overt CVD.

METHODS: Cross-sectional analysis of a prospective study including 901 individuals recruited between 2020 and 2023. All participants underwent a cardiac 82-Rubidium positron emission tomography/computed tomography scan to quantify MBF at rest and during pharmacologically induced stress, allowing for calculation of MFR. Linear regression, with/without interaction terms for sex, was used to test whether sex modified the association between MFR/MBF and risk factors.

RESULTS: Mean (SD) age was 65 (8.9) years, diabetes duration was 14 (8.4) years, and 266 (29.5%) were women. Women had higher MBF at rest and stress but had lower MFR (mean (SD) 2.44 (0.67) vs. 2.59 (0.77), p = 0.003) than men. A similar proportion of men and women (21.1% vs. 23.7%) had an MFR < 2. The decline in predicted MFR with age differed between sexes. At age 55, women had a mean MFR that was 0.29 lower than men (95% CI: – 0.44 to – 0.14), but by age 75, this difference had nearly disappeared (- 0.04, 95% CI: – 0.19 to 0.11). However, after adjustment for other risk factors, the interaction between sex and age was not statistically significant (p = 0.057). No other risk factors exhibited significant sex-dependent interactions.

CONCLUSIONS: In individuals with type 2 diabetes without overt CVD, women exhibited lower MFR than men, primarily due to higher MBF at rest, suggesting sex-related differences. While MFR declined in both sexes, the sex difference was more pronounced in younger individuals and diminished over time. These findings underscore the need for further research into sex-specific thresholds for MFR in cardiovascular risk stratification.

PMID:40251660 | DOI:10.1186/s12933-025-02717-5

Int Breastfeed J. 2025 Apr 18;20(1):32. doi: 10.1186/s13006-025-00724-6.

ABSTRACT

BACKGROUND: Breastfeeding offers critical benefits in disasters but faces significant barriers. In this study, we aimed to determine the association between experiencing the 2023 Türkiye earthquake and breastfeeding problems.

METHOD: This cross-sectional descriptive study was conducted in pediatric clinics in eight different provinces of Türkiye, three earthquake-affected provinces and five earthquake-unaffected provinces, between April and July 2023. Breastfeeding mothers and their 0-23 month infants were included in the study. A structured questionnaire was applied to mothers face-to-face. Multivariate logistic regression analysis was performed to determine independent parameters associated with breastfeeding problems.

RESULTS: A total of 761 mother-child pairs participated in the study. Among these mothers, 49% (n = 373) were living in the earthquake-affected region, and 51% (n = 388) were not. Breastfeeding problems were more common in the earthquake-affected mother-child pairs (48.8%) compared to unaffected pairs (28.6%). Perceived insufficient milk supply was the most common breastfeeding problem, reported by 33.0% in earthquake-affected regions and 11.1% in unaffected region. Breastfeeding problems were 2.01 times more common in mothers from earthquake-affected region (95% CI: 1.45, 2.77) and 1.66 times more common in those who bottle-fed their infants (95% CI: 1.45, 2.37). Perceived insufficient milk supply was 4.12 times more prevalent in earthquake-affected regions (95% CI: 2.73, 6.22) and 1.78 times higher in bottle-feeding mothers (95% CI: 1.23, 2.57). The likelihood of perceived insufficient milk supply was lower in mothers receiving mental health support (AOR: 0.53, 95% CI: 0.33, 0.84) and nutritional support (AOR: 0.49, 95% CI: 0.27, 0.89).

CONCLUSION: Perceived insufficient milk supply is the most common breastfeeding challenge reported by mothers affected by earthquakes, occurring more frequently than among mothers who were not affected. This issue is associated with increased bottle feeding, limited mental health support, and inadequate nutritional support. Addressing this issue through adherence to the International Code of Marketing of Breast-milk Substitutes, controlling donation and distribution of commercial milk formula to discourage bottle feeding, alongside ensuring nutritional and mental health support for mothers, could significantly mitigate breastfeeding difficulties during disasters.

PMID:40251658 | DOI:10.1186/s13006-025-00724-6

Eur J Med Res. 2025 Apr 19;30(1):310. doi: 10.1186/s40001-025-02583-7.

ABSTRACT

BACKGROUND: Identifying the risk of stroke in patients with atrial fibrillation (AF) presents a challenge, as existing tools such as the CHA2DS2-VASc score primarily emphasize medical history, affording relatively less attention to the electrocardiogram (ECG). Exploring HRV (heart rate-related variability) parameters could help refine risk prediction for thromboembolic ischemic stroke and enhance personalized management. This paper investigates how HRV parameters may inform the risk of acute ischemic stroke in atrial fibrillation patients.

METHODS: Data were retrospectively collected from Zhongnan Hospital’s electronic registry for patients with atrial fibrillation admitted in 2022. The sample was sorted into cases and controls based on specific inclusion and criteria. The outcome was the onset of acute ischemic stroke (AIS) in recurrent paroxysmal non-valvular atrial fibrillation. Cases and control data were analyzed using different statistical methods based on distribution, and the association between HRV parameters and the risk of stroke in paroxysmal atrial fibrillation was assessed. Binary logistic regression was utilized to assess a predictive model for stroke risk based on heart rate variability (HRV) parameters.

RESULTS: A total of 3218 medical records with atrial fibrillation were retrieved. Out of 3218 medical records with atrial fibrillation, 192 were selected after screening, including 93 cases and 99 controls. The cohort comprised 93 females (50 cases) and 99 males (43 cases). Mean ages were 68.67 ± 1.95 for cases and 68.35 ± 1.19 for controls, with no significant difference (P > 0.05). Hypertension history was significantly more common in cases (P = 0.006), indicating a dependency between hypertension and acute ischemic stroke in non-valvular paroxysmal AF. SDNN mean rank was significantly lower in cases (P = 0.024), and LF was significantly reduced (P = 0.044). Other HRV parameters showed lower values in cases, but differences were not statistically significant. We found that AVTD (abnormal variation in the time domain) alone was significantly associated with acute ischemic stroke in non-valvular paroxysmal AF. While AVFD (abnormal variation in frequency domain) and AVA (abnormal variation in arrhythmogenicity) were not individually significant, a combined variable (CDV) from AVTD, AVFD, and AVA was also statistically significant (P = 0.029). In this model, SDNN, AVTD, history of hypertension, as well as the CHA2DS2-VASc score and the use of novel anticoagulant medicines (NOACS), were significant predictors in both univariate and multivariate analyses. At the same time, CDV was significant only in univariate analysis. These findings may suggest that HRV parameters may provide clues to the risk of acute ischemic stroke in non-valvular paroxysmal AF.

CONCLUSION: This study found that abnormal variation in HRV parameters was more observed in patients with acute ischemic stroke. Then, unlike previous research, this study uniquely integrated multiple HRV parameters to develop novel indices such as AVTD, AVFD, AVA, and CDV, which somehow demonstrated a significant association with the risk of AIS. These new metrics, combined with conventional risk factors and CHA2DS2-VASc score, brought great improvement to the model prediction for AIS risk.

PMID:40251653 | DOI:10.1186/s40001-025-02583-7

BMC Rheumatol. 2025 Apr 18;9(1):44. doi: 10.1186/s41927-025-00498-8.

ABSTRACT

OBJECTIVES: Fatigue is a prominent symptom in patients with psoriatic arthritis (PsA). There was a wide variety of statistics previously reported on fatigue prevalence in patients. This systematic review examined the current literature to derive the overall prevalence of fatigue and risk factors in PsA patients.

METHODS: A systematic review of the literature with subsequent meta-analyses was conducted. Publications assessing fatigue severity and prevalence in patients with PsA using validated measurement scores were identified from seven online databases (Cochrane, CINAHL, EMBASE, Google Scholar, MEDLINE, PubMed, and Web of Science), from inception until January 2024. Employing a random effects model, we calculated the pooled fatigue prevalence. Quality assessment of included studies was performed utilising the Joanna Briggs Critical Appraisal Tool.

RESULTS: The final analysis included 15 studies with 6482 PsA patients. Pooled fatigue prevalence was 0.51 (95% CI: 0.41, 0.61; I2 = 97.4%). There was substantial heterogenicity across the studies, with biologics use and geographical location in terms of Western versus Eastern countries being possible sources of heterogeneity. Age, disease duration, gender, tender joint count, swollen joint and enthesitis count are among the most commonly reported risk factors for fatigue in multivariate logistic regressions.

CONCLUSIONS: Approximately half of the patients with PsA experienced fatigue. Biologics use and geographical location of the study were possible sources of heterogeneity in the subgroup analysis.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40251651 | DOI:10.1186/s41927-025-00498-8