Tag: nevin manimala

J Racial Ethn Health Disparities. 2026 May 1. doi: 10.1007/s40615-026-02995-z. Online ahead of print.

ABSTRACT

INTRODUCTION: The Hispanic population in the United States (U.S.) is rapidly growing. Prior research indicates that foreign-born women have lower neuraxial labor analgesia (NLA) rates than U.S.-born counterparts but influence of maternal country of origin remains unclear. This study examines the association between birthplace (foreign-born vs. US-born) and NLA during labor.

METHODS: This retrospective cross-sectional study utilized CDC WONDER’s Natality Expanded-Results Database (2016-2023) to analyze birth characteristics amongst several populous Hispanic subgroups. A Chi-Square test assessed overall differences in NLA by birthplace, Statistical significance was set at p < .05.

RESULTS: The study included 704,913 participants. Rates of NLA in U.S.-born mothers of Mexican origin were significantly higher than their foreign-born counterparts (80.30% and 74.2% respectively; absolute difference 6.1%, 95% CI: 5.9, 6.4). Rates of NLA in U.S.-born mothers of Cuban origin were significantly lower than their foreign-born counterparts (82.30% and 85/70% respectively, absolute difference-3.4, 95% CI: -4.3, -2.5). There was no difference in NLA between U.S.-born and foreign-born women of Dominican origin (81.40% and 76.70% respectively, absolute difference 4.8, CI: -6.0, 15.6). Of all the Hispanic origins, Cubans (both U.S. born and foreign-born) were most likely to use neuraxial labor analgesia (82.3% and 85.7% respectively). There is no significant difference in age of mother, birth weight, BMI, number of prenatal visits, and interval since last live birth between U.S.-born and foreign-born women of the same Hispanic origin (p>.05).

CONCLUSION: Intra-racial differences in NLA exist based on maternal birthplace and Hispanic origin, highlighting need for further research on cultural influences in obstetric pain management. These trends should be continuously monitored to formulate tailored public health interventions.

PMID:42065806 | DOI:10.1007/s40615-026-02995-z

Environ Monit Assess. 2026 May 1;198(5):536. doi: 10.1007/s10661-026-15379-x.

ABSTRACT

This study presents a long-term analysis of water quality using the National Sanitation Foundation Water Quality Index (NSFWQI) based on the monitoring data from 1966 to 2023 for the Sumida River in Tokyo. Although the NSFWQI has been widely used, it is not often applied to large, long-term datasets. This study illustrates how the NSFWQI can be effectively used for multidecadal analysis, allowing researchers to identify temporal dynamics and progressive changes in water quality. In this study, NSFWQI was developed from 27 sampling points using four to eight key parameters: transparency, temperature, pH, dissolved oxygen (DO), biochemical oxygen demand (BOD), nitrate, phosphate, and fecal coliform of the monthly dataset from 1966 to 2023. The results show that the overall water quality improved from poor in 1966 to good by 2012, driven mainly by reduced BOD and enhanced DO. Moreover, the analysis identified eight significant change points, indicating gradual improvements in water quality that correspond to major policy and infrastructure advancements. However, among eight water quality parameters, fecal coliform levels remained persistently high, indicating continuing microbial risks linked to diffuse sources and aging sewer infrastructure. The findings highlight how sustained governance and infrastructure investment can reverse urban river degradation, while emphasizing that chemical recovery alone is insufficient without microbial management. Incorporating WQI-based assessments into Japan’s monitoring frameworks could enhance adaptive water governance and public communication of river health.

PMID:42065793 | DOI:10.1007/s10661-026-15379-x

Environ Monit Assess. 2026 May 1;198(5):537. doi: 10.1007/s10661-026-15339-5.

ABSTRACT

Land use land cover (LULC) changes are key indicators of environmental transformation, directly influencing hydrological balance, ecosystem services and sustainable land management. Sher River basin, an agro-ecological diverse sub-basin of the Upper Narmada River system in India, is the primary hydrological and socio-economic lifeline for local communities, but no comprehensive study on Sher River basin related to long term LULC dynamics could be tracked in the literature. To fulfil this research gap, long term LULC spatiotemporal change detection and transition patterns analysis with a dual-seasonal focus on the Rabi and Kharif cropping periods over a 23-year period (2001-2023) in Sher River basin are carried out. LULC maps are created using multi-sensor Landsat data (TM, ETM+ , OLI/TIRS) for 2001, 2006, 2011, 2016 and 2023 at an interval of 5 years for both Rabi and Kharif seasons using a supervised classification technique with the maximum likelihood classifier. Five LULC classes, namely, built-up, agricultural, forest, water body and barren land are delineated. All classified maps achieved overall accuracies exceeding 85% with kappa coefficients greater than 0.80. The agricultural land increased significantly in both seasons, more sharply during Rabi (5.86% to 10%) while built-up areas expanded more than fivefold (0.18% to 0.85%) reflecting rapid urbanization during 23 years. Barren land declined noticeably, transitioning mainly into agricultural and urban land uses. Forest cover, after an initial decline, showed recovery post 2016 with a modest increase in the later years due to afforestation initiatives. Water bodies remained relatively stable with minor seasonal variations. This study provides critical insights into seasonal land dynamics, highlighting clear seasonal contrasts in land use behavior between Rabi and Kharif periods. The findings emphasize the need for integrated land use planning to balance agricultural growth, urban expansion and ecological sustainability in sub-humid watersheds.

PMID:42065792 | DOI:10.1007/s10661-026-15339-5

Environ Monit Assess. 2026 May 1;198(5):538. doi: 10.1007/s10661-026-15325-x.

ABSTRACT

This study presents a vision-based framework for accurate vehicle speed estimation and real-world emission assessment at urban signalized intersections under challenging weather conditions. Using a publicly available dataset recorded in Curitiba, Brazil, comprising five videos (total duration 132 min) captured by a single low-cost 5 MP camera under cloudy, sunny, dusty, heavy rain, and low-visibility conditions, vehicles were detected with YOLOv11 and tracked using ByteTrack. Speed was estimated through a monocular vision pipeline calibrated against radar ground truth. The proposed speed estimation method achieved outstanding accuracy, with mean absolute error (MAE) ranging from 0.38 to 0.84 km/h and standard deviation below 0.96 km/h across all weather scenarios, significantly outperforming existing vision-only approaches. Two emission models were implemented: (1) MOVESTAR using measured speeds and vehicle classification, and (2) SUMO with real trajectory enforcement via TraCI to create a high-fidelity digital twin of the intersection. When the whole four-lane region was analyzed (439 vehicles total), MOVESTAR yielded average emissions of CO₂ 2.02 g/mi, HC 0.018 g/mi, NOx 0.058 g/mi, and fuel consumption 93.15 g/mi. After unit standardization to g/km and statistical comparison via paired t-tests, MOVESTAR consistently produced significantly lower and more realistic emission estimates than SUMO for fuel, CO₂, NOx, and HC (p < 0.01), with CO₂ and fuel showing the most significant differences (- 12 g/km and – 18.57 g/km, respectively). Heavy rain and dusty conditions were identified as the most challenging environments, whereas cloudy and sunny weather provided the highest accuracy.

PMID:42065790 | DOI:10.1007/s10661-026-15325-x

Exp Appl Acarol. 2026 May 1;96(4):48. doi: 10.1007/s10493-026-01137-8.

ABSTRACT

Spider mites, particularly Tetranychus urticae Koch and T. turkestani Ugarov and Nikolskii (Acari: Tetranychidae), are major agricultural pests, and their increasing resistance to chemical acaricides underscores the need for alternative control strategies. This study explored the biocontrol potential of Trichoderma spp. against these mites. Specifically, we evaluated (1) the efficacy of spore suspensions from five isolates of four Trichoderma species (Trichoderma afroharzianum, T. guizhouense, T. harzianum and T. virens) and their combinations on different biological stages of T. urticae, (2) the efficacy of T. afroharzianum spore suspension on different populations of T. urticae (green and red forms) and T. turkestani in both Petri dish and pot experiments. Results showed that Trichoderma spore suspensions were ineffective against T. urticae eggs, with mortality rates ≤ 2.8% at 7 days post-application (dpa), which did not differ significantly from the control. However, the fungi caused significant mortality of 50-65% in the mobile stages of the mites (larvae, nymphs, and adult females) compared with the control. Based on the initial screening results, a single Trichoderma isolate (T. afroharzianum) was selected for detailed assessment across multiple spider mite populations. Petri dish assays at 7 dpa showed that T. afroharzianum was more effective against T. turkestani (up to 60%) and the green form of T. urticae (53%) than against the red form of T. urticae (35%). Pot experiments confirmed these results, showing that T. afroharzianum reduced egg and mobile stage populations by 36-39% in T. turkestani and T. urticae (green form and laboratory culture populations), whereas reductions in the red form of T. urticae were not statistically significant. These findings suggest that T. afroharzianum has potential as a biological control agent; however, its efficacy varies among spider mite populations, highlighting the need to integrate it with other biological or chemical strategies.

PMID:42065786 | DOI:10.1007/s10493-026-01137-8

J Gastrointest Cancer. 2026 May 1;57(1):104. doi: 10.1007/s12029-026-01476-0.

ABSTRACT

PURPOSE: Total Neoadjuvant treatment (TNT) has now become the standard of care in locally advanced rectal cancer(LARC) and has shown promising results. However, use and outcome of different TNT regimens in real-world practice is largely unknown.Here we report the feasibility and efficacy of RAPIDO regimen which we adopted since 2021 for LARC.

MATERIALS AND METHODS: A retrospective review of prospectively collected data, conducted at Tata Medical Center, Kolkata between January 2021 to June 2024. 95 consecutive patients with localized rectal adenocarcinoma, treated with short course radiotherapy 25 Gy/5frs/1week followed by CAPOX based chemotherapy with or without surgery were analysed. Data was collected in the Redcap Database.

RESULTS: The median age of the cohort was 53 years. Lower rectal disease, T4,N2,EMVI(Extramural Vascular Invasion) Grade 3/4, MRF (Mesorectal fascia) involvement were seen in 51(54%), 21(22.1%), 86(90.5%), 58(61%) and 70 (73.7%)patients respectively.62 patients (65.2%) underwent surgery. Pathological complete response (pCR) was achieved in 27.4%(17/62) cases. At a median follow-up of 2.4 years,43 patients (45.3%) underwent TNT and surgery and are disease free on follow up. Local failure was seen in 2 patients after surgery(3.2%)0.17 of 62 patients (27.4%) who underwent surgery developed distant metastasis with lung being the most common site (16.1%). The estimated 3 year overall survival of all patients was 83% and for patients who underwent surgery 3-year OS was 92% and 3-year disease free survival(DFS) was 63% Maximum grade≥ 3 diarrhoea and febrile neutropenia during chemotherapy were observed in 17 (17.9%) and 14 (14.7%) patients respectively.

CONCLUSION: RAPIDO protocol in real world settings shows excellent response rates in LARC. It is a safe and feasible approach, however implementing a prolonged neoadjuvant treatment in the real world remains a challenge because of suboptimal compliance.

PMID:42065776 | DOI:10.1007/s12029-026-01476-0

Int J Biometeorol. 2026 May 1;70(5):151. doi: 10.1007/s00484-026-03214-4.

ABSTRACT

Agriculture is highly sensitive to climate variability, and ongoing warming is expected to modify the thermal conditions controlling fruit tree phenology and production. This study analyzes the spatiotemporal variability of winter chilling, spring heat accumulation, and spring frost probability across fruit-growing areas in Aragón (northeast Spain) using a regional, high-resolution agroclimatic approach. Chill portions (CP), growing degree hours (GDH), and spring frost probability occurrence (SFPO) were computed from daily gridded maximum and minimum temperature data at 1 km² spatial resolution. Agroclimatic indicators were derived using statistical, non-experimental methods based on established chilling and forcing models and empirical temperature thresholds. Recent historical variability was characterized using overlapping 30-year historical climate periods while future climate conditions were assessed using daily temperature projections from an ensemble of 18 regional climate models (EURO-CORDEX), dynamically downscaled from global climate models and bias-corrected. Projections were analyzed for a historical reference period (1971-2000) and under the intermediate and high emissions scenario RCP4.5 and RCP8.5 for mid-century (2041-2070) and late-century (2071-2100) periods. Climate projections at ~ 5 km spatial resolution were interpolated to 1 km and bias-corrected using Empirical Quantile Mapping with high-resolution observational data as reference. Changes in CP and GDH distributions were quantified using spatial differences and standardized anomalies relative to historical conditions, and indicators were extracted at the location of existing fruit orchards. Results indicate that effective winter chilling remains within broad ranges compatible with fruit production across all scenarios, with persistent spatial contrasts between western and eastern sectors. In contrast, spring heat accumulation shows a strong and spatially coherent increase, particularly in low-elevation and eastern areas, indicating an increasing influence of spring temperatures on phenological dynamics. Although future scenarios project a substantial reduction in the probability of frost occurrence after early March, increasing heat accumulation may advance phenological development, potentially shifting frost exposure to earlier periods in late winter. Overall, the results indicate that agroclimatic conditions in Aragón are strongly structured by regional climatic gradients, and that climate change is likely to intensify spatial contrasts between colder and warmer production areas rather than producing uniform changes across the region. These results provide a regional agroclimatic framework that can support adaptation planning and the long-term management of fruit production under climate change.

PMID:42065754 | DOI:10.1007/s00484-026-03214-4

Medicine (Baltimore). 2026 May 1;105(18):e48146. doi: 10.1097/MD.0000000000048146.

ABSTRACT

Pharmaceutical Care (PC) has emerged as a vital component of the healthcare system, involving the provision of medication therapy to achieve specific outcomes that enhance a patient’s quality of life. Therefore, this study aims to evaluate PharmD interns’ self-reported attitudes, perceptions of the skills required to provide PC using multiple domains (technical, psychosocial, communication, and administrative aspects) and perceived barriers to implementing PC, and recommendations. A cross-sectional study was conducted between May and December 2023, utilizing pretested questionnaires with PharmD interns at Saudi universities in Riyadh, Saudi Arabia. The questionnaire included sociodemographic information, attitudes (13 items), perceptions (24 items), importance (19 items), barriers (17 items) toward PC, and recommendations (4 items). To find out the association between variables chi-square, Analysis of Variance, and Spearman correlation were used to examine differences in perceptions and correlations between attitude and perception scores, with a P value < .05 considered statistically significant. A total of 216 PharmD interns participated, with 59.7% being male, 94.9% Saudi nationals, and a mean age of 24.08 ± 0.98 years. The majority (72.7%) were 24 years old. Participants were from public (57.9%) and private (42.1%) universities in Riyadh. The mean attitude score towards PC was 51.25 ± 9.38, and the mean perception score was 106.67 ± 16.01. Attitude scores were significantly associated with gender and university type (P < .001), while perception scores showed significant associations with gender, age, and university type (P < .01). The results of the Spearman correlation analysis indicated a moderate, statistically significant positive correlation between mean attitude and mean perception scores (R = 0.345, P < .01). Most interns agreed that pharmacists should prevent and solve medication-related problems (86.6%) and provide PC (85.7%). However, 43.5% believed that PC is not worth the additional workload. The most frequently reported barriers were lack of financial compensation (65.8%), inadequate staffing (62.5%), limited private counseling areas (60.7%). Most of the PharmD interns have a positive attitude towards PC but face structural and educational barriers to PC implementation. Future research should focus on overcoming these barriers and promoting Interprofessional healthcare courses to enhance patient outcomes.

PMID:42065214 | DOI:10.1097/MD.0000000000048146

Medicine (Baltimore). 2026 May 1;105(18):e48537. doi: 10.1097/MD.0000000000048537.

ABSTRACT

Unintentional poisoning and exposure to harmful substances involving illicit drugs, medications other than those taken as prescribed, and biological substances have emerged as a leading cause of preventable death in the United States. The increase in drug-specific toxicity, particularly from synthetic opioids, has accelerated during the COVID-19 pandemic, thus highlighting a need for national surveillance to monitor emerging demographic and geographic patterns. The CDC WONDER Multiple Cause of Death database provided mortality data from 1999 to 2023. Deaths with accidental poisoning (International Statistical Classification of Diseases and Health-Related Problems-10th Revision codes X40-X49) coded as the underlying cause and poisoning due to drugs (T36-T50) as multiple causes were considered. Age-adjusted mortality rates were extracted from the SEER database (number of deaths per 100,000 individuals). They were analyzed according to sex, age strata, race/ethnicity, and geographic region via Joinpoint regression for estimation of annual percentage change and average annual percentage change, with statistical significance set at P < .05. From 1999 to 2023, all-ages age-adjusted mortality rates more than sextupled, from 4.8 (95% confidence interval: 4.7-4.9) to 30.8 (95% confidence interval: 30.6-31.0). The consistently higher male mortality culminated in 2022, where men had a crude mortality of 45.3 per million compared with 18.2 per million in women. The largest increase was from 2019 to 2020, after the start of the COVID-19 pandemic. It is most severe among middle-aged adults (ages 45-64) and is characterized by geographic disparities in mortality, with clustering in counties across the Appalachian region and Southern United States. Non-Hispanic Black and American Indian/Alaska Native people experienced the latest spikes in mortality. The ongoing rise in drug-related accidental poisonings indicates a growing, evolving epidemic in the United States. The findings identified a need for focused equity-based interventions targeting substance use treatment, social determinants of health, and enhanced surveillance to address the escalating burden of mortality due to drug toxicity.

PMID:42065199 | DOI:10.1097/MD.0000000000048537

Medicine (Baltimore). 2026 May 1;105(18):e48545. doi: 10.1097/MD.0000000000048545.

ABSTRACT

Early detection of cognitive dysfunction through reliable biomarkers remains a critical challenge in geriatric medicine. While conventional peripheral blood parameters offer convenient and cost-effective biomarker potential, previous studies have been limited by their focus on isolated cell populations. This study investigates both individual blood cell parameters and their derived ratios to comprehensively evaluate their relationship with cognitive function. In this cross-sectional conducted from 2022 to 2024, we enrolled 109 participants (51 with cognitive impairment and 58 controls) from the Haikou City Community Health Service Center. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). We analyzed 26 blood parameters, including traditional metrics and calculated indices such as lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index (SII). The relationship between these parameters and cognitive domains was evaluated using comprehensive statistical analyses. Fifteen parameters showed significant differences between groups. Binary logistic regression identified SII as a risk factor (OR: 1.008, 95% CI: 1.003-1.012, P = .002). The receiver operating characteristic curve analysis indicated that the diagnostic accuracy of SII (AUC = 0.911, 95% CI: 0.856-0.966) was significantly superior to that of the sole parameter, the number of lymphocyte count (AUC = 0.702, 95% CI: 0.604-0.801). Our findings suggest that lower lymphocyte counts and elevated SII levels are associated with increased risk of cognitive impairment. These results provide new insights into the relationship between systemic inflammation and cognitive decline, with potential implications for clinical practice.

PMID:42065191 | DOI:10.1097/MD.0000000000048545