Tag: nevin manimala

Surg Endosc. 2025 Oct 13. doi: 10.1007/s00464-025-12263-6. Online ahead of print.

ABSTRACT

BACKGROUND AND STUDY AIM: Super minimally invasive surgery (SMIS) via endoscopic submucosal tunnel dissection (ESTD) has shown promising preliminary efficacy for the treatment of large early esophageal cancer (EEC). This study reports the short- and long-term outcomes of both single- and double-tunnel ESTD for large EEC.

PATIENTS AND METHODS: All 90 patients with large EEC underwent ESTD at three hospitals between December 2013 and March 2024. We divided patients into two groups (single-tunnel SMIS and double-tunnel SMIS).

MAIN OUTCOME MEASUREMENTS: rates of en bloc resection, complete resection (R0 resection), curative resection, dissection speed and complications were evaluated as short-term outcomes. Overall survival, local or distant recurrence, and postoperative stricture rates were evaluated as long-term outcomes.

RESULTS: For all patients, the en bloc and R0 resection rates were 97.8% and 67.8%, respectively. Post-ESTD bleeding and fever were detected in 8.9% and 17.8% of the procedures, respectively. Postoperative stenosis and recurrence occurred in 54 patients (60.0%) and 7 patients (9.5%), respectively. Among the 90 patients with different circumferential-extent lesions, those who received a double-tunnel ESTD procedure (n = 54) underwent dissection faster than those who received a single-tunnel ESTD procedure (n = 36, 0.25 vs. 0.19 cm²/min, P = 0.012). No statistically significant differences were observed between the two groups in terms of short-term postoperative complications, postoperative esophageal stenosis, survival or recurrence rates (P > 0.05). Multivariate regression analysis revealed that whole-circumferential lesions were an independent risk factor for technical difficulties.

CONCLUSION: ESTD was effective for treating large early esophageal carcinoma. Compared with single-tunnel ESTD, double-tunnel ESTD has a faster resection speed, and there was no significant difference in short-term postoperative complications or long-term follow-up results. Therefore, double-tunnel ESTD is safe, reliable and more efficient in the treatment of large EEC.

PMID:41083611 | DOI:10.1007/s00464-025-12263-6

Sci Rep. 2025 Oct 13;15(1):35745. doi: 10.1038/s41598-025-21604-3.

ABSTRACT

This paper proposes a novel hybrid image encryption scheme that combines a memristor-based hyperchaotic system, the Trivium stream cipher, DNA-inspired operations, and a lightweight 3DES layer into a tightly integrated multi-layer architecture. The memristor-based chaotic system ensures a large key space and complex dynamics, while the Trivium cipher enhances randomness, and the DNA operations introduce strong confusion and diffusion properties. The addition of 3DES further reinforces resistance against brute-force and structural attacks. Extensive experiments demonstrate the effectiveness of the proposed algorithm: the information entropy of encrypted images approaches the ideal value (7.999), the correlation coefficients between adjacent pixels are reduced to nearly zero (≈ 0.001), and differential attack metrics achieve NPCR values above 99.58% and UACI values above 33%. Furthermore, the scheme exhibits robustness against data loss and noise (up to 20% salt-and-pepper noise) with minimal degradation in decrypted images. Hardware implementation on the NVIDIA Jetson TX2 confirms the practicality of the method for embedded and edge-computing environments. These results indicate that the proposed scheme provides a secure, efficient, and hardware-friendly solution for modern image encryption applications.

PMID:41083577 | DOI:10.1038/s41598-025-21604-3

Sci Rep. 2025 Oct 13;15(1):35750. doi: 10.1038/s41598-025-20590-w.

ABSTRACT

This study aimed to investigate the presence of neuropathic pain and its associated factors in patients diagnosed with the hemoglobinopathies thalassemia major (TM) and sickle cell disease (SCD). This study included 27 patients with TM and 30 patients with SCD who presented to the neurology clinic between 2022 and 2023. All participants had normal electromyography (EMG) findings and nerve conduction studies. Patients aged between 20 and 50 years were evaluated for neuropathic pain using the Neuropathic Pain Scale (DNET-4). Data were analyzed in relation to age, sex, smoking status, hemoglobin levels, platelet count, ferritin levels, presence of depression, use of hydroxyurea and chelation therapy, and splenectomy status. Depression was assessed using the Beck Depression Inventory. Patients with neuropathy due to anatomical pathology, lumbar disc herniation, diabetes mellitus, prior use of neurotoxic drugs, or clinical signs of peripheral nerve involvement were excluded from the study. The mean age was 29.22 years in the TM group and 32.03 years in the SCD group (p = 0.010). Neuropathic pain was reported by 37.1% of patients with TM and 46.7% of those with SCD, with higher pain scores tending to occur in the sickle cell group (p = 0.069). A statistically significant difference and moderate positive correlation were found between neuropathic pain and hydroxyurea treatment (p < 0.01). No significant difference was observed between the groups in terms of depression levels (p = 0.63); however, a strong positive correlation was found between depression severity and neuropathic pain scores (p < 0.001). As depression levels increased, neuropathic pain severity also increased. The TM group had significantly lower hemoglobin levels (8.21 ± 0.92 g/dL) compared to the SCD group (10.03 ± 1.45 g/dL) (p < 0.001). Ferritin levels were significantly higher in the TM group (2678 ± 1689 ng/mL) than in the sickle cell group (580 ± 689 ng/mL) (p < 0.001). No statistically significant associations were observed between neuropathic pain and chelation therapy, splenectomy, or smoking status. Neuropathic pain in patients with TM and SCD was significantly associated with depression severity. Hydroxyurea treatment showed a moderate association with neuropathic pain in patients with SCD, potentially reflecting greater disease burden. These findings underscored the importance of comprehensive clinical evaluation, including both neurological and psychological assessments, in the management of these patients.

PMID:41083566 | DOI:10.1038/s41598-025-20590-w

Sci Rep. 2025 Oct 13;15(1):35604. doi: 10.1038/s41598-025-17699-3.

ABSTRACT

The increasing adoption of Connected and Autonomous Vehicles (CAVs) within intelligent transportation systems has amplified concerns over cybersecurity threats in the Internet of Vehicles (IoV). To address the limitations of centralized Intrusion Detection Systems (IDS), we propose an Adaptive Personalized Federated Learning (APFed) model integrated with a Lightweight Depthwise Convolutional Bottleneck Network (LDwCBN). The system is designed to ensure privacy-preserving, resource-efficient, and accurate intrusion detection under heterogeneous and non-IID data conditions. APFed enhances model personalization and generalization through fine-grained adaptive updates and dynamic weight fusion, while LDwCBN improves detection speed and efficiency on constrained vehicular hardware. Extensive evaluations on benchmark datasets, including CIC-IDS2017, CSE-CIC-IDS2018, Car-Hacking, and CAN-Train-Test, demonstrate that the proposed method outperforms several state-of-the-art federated IDS approaches. Specifically, it achieves accuracy improvements of up to 5% over FedAvg and FedProx models, with significant gains in precision (up to 4%), recall (up to 3%), and F1-Score (up to 4%).

PMID:41083537 | DOI:10.1038/s41598-025-17699-3

Sci Rep. 2025 Oct 13;15(1):35640. doi: 10.1038/s41598-025-19659-3.

ABSTRACT

Given the continued emergence of SARS-CoV-2 variants of concern as well as unprecedented vaccine development, it is crucial to understand the effect of updated vaccine formulations at the population level. While bivalent formulations developed during 2022 have had higher efficacy in vaccine trials, translating these findings to real-world effectiveness is challenging due to diversity in immune history, especially in settings with a high degree of natural immunity. Known socioeconomic disparities in key metrics such as vaccine coverage, social distancing, and access to healthcare have likely shaped the development and distribution of this immune landscape. Yet little has been done to investigate the impact of booster formulation in the context of host heterogeneity. Here, we present work undertaken in 2022-2023 to inform the World Health Organization’s Immunization and Vaccines Related Implementation Research Advisory Committee (IVIR-AC), at a time when policymakers were considering optimal boosting strategies. Using two complementary mathematical models that capture host demographics and immune histories over time, we investigated the potential impacts of bivalent and monovalent boosters, inspired by disease dynamics in low- and middle-income countries (LMICs). These models allowed us to test the role of natural immunity and cross-protection in determining optimal booster strategy. Our results show that in hypothetical populations with high pre-existing immunity in the 2022-23 season, disease-related deaths from a new variant would be more sensitive to boosting/no boosting than booster formulation (bivalent vs. monovalent) – and if using bivalent formulations would result in delayed implementation compared to monovalent, it would almost always be better to implement monovalent immediately. However, deaths might be more sensitive to bivalent formulations in populations with low pre-existing immunity. These findings suggest that for many places where acquiring new vaccine stock may be economically prohibitive, monovalent boosters could still have been implemented where pre-existing immunity was high. While this analysis focuses on policy concerns in 2022, these results remain relevant now amidst ongoing questions about optimal booster formulation and timing to combat emerging transmission waves of COVID-19.

PMID:41083528 | DOI:10.1038/s41598-025-19659-3

Sci Rep. 2025 Oct 13;15(1):35622. doi: 10.1038/s41598-025-19488-4.

ABSTRACT

The landscape of academic publishing has evolved dramatically, leading to a surge in publications and journals. The ‘publish or perish’ culture has resulted in undesirable practices, such as many researchers publishing in predatory journals due to institutional pressures and lack of awareness. While numerous studies have investigated knowledge of predatory journals, overall research literacy has remained underexplored. This study is the first to assess research literacy comprehensively, incorporating GIS and machine learning techniques alongside traditional statistical analyses. This study utilized a cross-sectional survey method with a questionnaire collecting information on socio-demographics, academic information, research training and experience, and research literacy. Traditional statistical analyses were performed using SPSS, while machine learning models were developed with Python and Google Colab. Supervised classification algorithms and mapping with R statistical software’s ‘bangladesh’ package. The findings revealed that over half of the participants had poor research literacy. Significant predictors of higher research literacy included satisfaction with research courses at university education, research course taken outside university , and research-related professional engagement. Machine learning analysis identified that taking research courses outside of university was the most impactful factor for research literacy, while researchers within family members had minimal influence. The Random Forest and CatBoost models performed strongly in predicting literacy, achieving accuracy rates of 73.04% and 71.57%, respectively, and precision values of 73.29% and 71.69%, respectively, with low log loss values of 0.57 and 0.56. GIS-based spatial analyses revealed regional disparities in research literacy (χ²=9.234, p = 0.236), with certain divisions exhibiting a higher prevalence of lower literacy. This study highlights that a substantial portion of the participants lack research literacy, which is associated with multiple factors. The findings suggest the need for intervention programs to enhance research practices and awareness among students and professionals, fostering a culture of academic excellence.

PMID:41083527 | DOI:10.1038/s41598-025-19488-4

Sci Rep. 2025 Oct 13;15(1):35627. doi: 10.1038/s41598-025-19630-2.

ABSTRACT

Understanding clinical outcomes following tympanoplasty is essential for effectively counseling patients and providing a comprehensive perspective on its benefits and limitations. To evaluate the effects of tympanoplasty on ear-related clinical symptoms, hearing function, health-related quality of life (HRQol), and symptoms of depression and anxiety. A randomized, non-blinded clinical trial was conducted. Patients scheduled for tympanoplasty were compared with a control group of individuals on the surgical waiting list. A single academic tertiary care center. The study included 111 participants (41 males [36.94%], 70 females [63.06%]; mean age = 34.41 ± 12.78 years) with dry tympanic membrane perforations. Among them, 63 underwent tympanoplasty, with success and failure rates of 33:18 (64.71%: 35.29%) at 3 months, and 22:16 (57.89%: 42.11%) at 6 months. The remaining 48 served as controls, with 43 (89.58%) followed up at 3 months. Tympanoplasty was evaluated at three time points-preoperatively (T0), and postoperatively at 3 months (T3) and 6 months (T6). Primary outcomes included scores from the Arabic version of the Ear Outcome Survey-16 (EOS-16) and the Arabic Version of the Hospital Anxiety and Depression Scale (HADS), assessed at T0, T3, and T6. For successful tympanoplasty: the Overall_Q1-14 score ((30.41 ± 12.09), (15.36 ± 6.97) and (15.55 ± 6.88), n = 22, p < 0.001), for failed tympanoplasty: the Overall_Q1-14 score ((25.69 ± 11.84), (21.94 ± 9.81) and (21.31 ± 11.85), n = 16, p = 0.3) and for controls: the Overall_Q1-14 score ((27.02 ± 12.88) and (26.49 ± 13.26), n = 43, p = 0.59). Almost all distinct items showed statistical significance p < 0.05 after successful tympanoplasty against none after failure tympanoplasty while controls remained unchanged. Multiple linear regression equation of depression score (T3-T0) in successful tympanoplasty “Y_depression = (2.44 + 0.162x_Overall + 0.156x_AC) + Ɛ_depression“. Successful tympanoplasty significantly improved ear symptoms, hearing function, psychosocial well-being, and overall health-related quality of life. Although it had no immediate or direct effect on depression or anxiety, improvements in hearing and quality of life were predictive of reductions in depressive symptoms. These findings highlight the broader psychosocial benefits of tympanoplasty and support its role in holistic patient care.Trial registration This study was registered with ANZCTR (ACTRN12625000436471) on 09/05/2025.

PMID:41083521 | DOI:10.1038/s41598-025-19630-2

Sci Rep. 2025 Oct 13;15(1):35677. doi: 10.1038/s41598-025-19554-x.

ABSTRACT

In stratified random sampling, precise variance estimation is essential especially when supplementary information is provided. This article presents an innovative Tailored Ratio-Integrated Variance Estimation employing Neyman Allocation Implementation (TRIVENI), which effectively combines ratio-based modifications to improve variance estimation. Despite traditional methods, TRIVENI leverages two auxiliary variables in multiple ways to measure the combined effect on population variance estimations. Applying Neyman allocation, it effectively distributes the sample among strata, ensuring minimal variance and improved precision. The combined use of ratio estimation promotes the application of auxiliary information, hence reducing estimate bias and enhancing accuracy. Theoretical derivations and simulation studies confirm that TRIVENI surpasses traditional estimators, demonstrating improved efficiency in various stratification contexts. The proposed methodology signifies a significant advancement in stratified variance estimation, rendering it a crucial instrument for survey sampling experts and researchers.

PMID:41083518 | DOI:10.1038/s41598-025-19554-x

Sci Rep. 2025 Oct 13;15(1):35613. doi: 10.1038/s41598-025-18923-w.

ABSTRACT

Injury and violence is a global public health concern, implicated in 4.4 million deaths annually. The most common cause of preventable death is haemorrhage in the out-of-hospital setting. Haemorrhagic shock patients are at risk of disseminated intravascular coagulation, global myocardial ischemia, and death. This risk is heightened among the young, older adults, or polytraumatised. The definitive standard of care is to stop the bleeding and to replace the lost haemoglobin whilst supplementing oxygen. There is paucity in emergency blood transfusion research in the out-of-hospital setting. It is not out-of-hospital standardised practice. This novel research conducted in Western Cape, South Africa, determined the viability of blood in transit by evaluating haemolysis and oxidative stress in Packed Red Blood Cells (PRBC) on public ambulances. A relatively new statistical method (generalised additive model with smooth term) was used to model non-linearity in the haemolysis trend. In a designed experiment, the viability of blood was determined by placing PRBC in temperature-controlled refrigerators at ambulance bases (maintained at 1-6 °C) as a ‘Control’. The ‘Treatment’ PRBC were transported in cooler-boxes with 2 eutectics (icepacks). The cold-chain was monitored against the recommended transportation temperature range of 1-10˚C. The PRBC was assessed weekly for haemolysis and at the end of the study for lipid peroxidation, both threats to PRBC viability following environmental exposure (to transit temperatures and movement). The PRBC placed on ambulances indicated that they were < 0.8% haemolysis threshold after day 35. Three packs in the treatment group were > 0.8% on day 42, along with one in the control group (which was deemed an outlier). Transported PRBC remained between 1-10˚C for the most part. Conjugated dienes and thiobarbituric acid reactive substances showed no statistically significant changes and aligned with colorimetric assessment. The blood viability on ambulances remained within the acceptable ≤ 0.8% haemolysis level until the PRBC expiry, on day 42. PRBC remained within the transportation temperature reference range for South Africa and no significant oxidative stress or cellular degradation was documented. This evidence supports PRBC viability when transported in ambulances conditional to the use of eutectics in closed cooler boxes and has relevance in low- and middle-income countries or in humanitarian contexts.

PMID:41083514 | DOI:10.1038/s41598-025-18923-w

Sci Rep. 2025 Oct 13;15(1):35684. doi: 10.1038/s41598-025-19507-4.

ABSTRACT

Malaria and soil-transmitted helminths (STHs) infections continue to be public health burden in Cameroon. This study investigates the prevalence, severity and impact of Malaria and soil-transmitted helminth infections on haemoglobin levels among armed forces in the North West and South West Regions of Cameroon. This cross-sectional study enrolled 812 male participants in the military camps of the North West and South West regions of Cameroon. Questionnaire survey was used to document participants demographic and clinical data. Venous blood was collected and used for testing malaria parasitaemia by microscopy as well as measurement of haemoglobin (Hb) levels using an Hb metre. Also, the direct smear method and Kato-Katz technique were used to detect intestinal parasites amongst the participants. The study identified two Plasmodium species, Plasmodium falciparum and Plasmodium vivax, with an overall prevalence of 13.6%. Equally, Loa loa microfilaria was identified during the study with a prevalence of 0.2% (2/812). Five intestinal helminthic species were also identified, including Ascaris lumbricoides, Trichuris trichiura, hookworms, Schistosoma mansoni, and Schistosoma intercalatum. Two intestinal protozoan species, Entamoebacoli and Entamoeba histolytica were recorded. The overall prevalence of intestinal parasites was 22.8%. Plasmodium falciparum was the most prevalent parasite with 86.6% of infected participants having mild malaria. The parasitic density was significant across age groups. Malaria parasites, Trichuris trichiura and Schistosoma mansoni significantly affected the mean Hb concentration level. Malaria and intestinal helminths remain public health issues in Cameroon, affecting haemoglobin levels. Asymptomatic malaria and intestinal helminthic carriers are transmission agents, necessitating government consideration to eradicate or limit transmission rates.

PMID:41083508 | DOI:10.1038/s41598-025-19507-4