Tag: nevin manimala

J Expo Sci Environ Epidemiol. 2026 May 6. doi: 10.1038/s41370-026-00903-5. Online ahead of print.

ABSTRACT

BACKGROUND: The physical school environment is a key factor influencing illness-related absences, particularly those caused by infectious diseases transmitted through air and surfaces. Previous studies, often underpowered, have been unable to conclusively quantify the impacts of improved classroom indoor environmental quality (IEQ) on illness-related absences, while also accounting for sociodemographic factors, such as gender and ethnicity.

OBJECTIVE: This study evaluates the impacts of district-wide renovations on student absences due to specific illness types, based on exceptional district data on daily absenteeism and socioeconomic factors, covering 1217 school days and 45,428 students.

METHODS: Between 2016 and 2021, over 45 schools in a district located in a mountain west region of United States underwent comprehensive renovations, which included upgrading heating, ventilation, and air conditioning systems. At the same time, cleaning protocols were developed to reduce surface contamination. Data from pre- and post-renovation monitoring included classroom temperature, relative humidity, and surface biocontamination levels. Carbon dioxide levels were used to estimate ventilation rates, while temperature and relative humidity were used to estimate absolute humidity.

RESULTS: Independent associations between illness-specific absences and school renovations, along with several IEQ parameters, were quantified. Based on the results, over one-third of absences due to respiratory illnesses could be reduced by keeping school facilities up to date and adhering to recommended standards for ventilation. Increased frequency of cleaning could help to reduce absences due to gastrointestinal illnesses. Additional reductions could be achieved by maintaining higher humidity and cooler temperatures in classrooms.

SIGNIFICANCE: These findings highlight the importance of maintaining good IEQ in schools, resulting in fewer absences from infectious diseases.

IMPACT: The study is based on a large-scale natural experiment, incorporating daily student-level absence data specifying illness types and background information for all students in the district, collected over seven school years – the longest follow-up period to date, to our knowledge. These data, combined with state-of-the-art IEQ monitoring conducted before and after the renovation of 45 schools, provides superior statistical power to quantify the impacts of renovations and how IEQ parameters may partially explain their effects on illness-related absences. The findings can inform policies at the school, district, and national levels, guiding renovations, maintenance and operational practices aimed at reducing airborne pathogens and surface contamination, and reducing illness-related absenteeism in schools.

PMID:42092110 | DOI:10.1038/s41370-026-00903-5

Rev Gaucha Enferm. 2026 May 1;47:e20250179. doi: 10.1590/1983-1447.2026.20250179.en. eCollection 2026.

ABSTRACT

OBJECTIVE: To estimate the association between sociodemographic and economic factors, prenatal care, and health-related risk and protective behaviors among pregnant women with gestational diabetes mellitus.

METHOD: This was a cross-sectional study with data collected between November 2023 and March 2024 from 391 pregnant women in a maternity hospital in Belo Horizonte, Minas Gerais, Brazil. Data collection was carried out through interviews using a semi-structured questionnaire. Poisson regression was used for data analysis.

RESULTS: Fruit consumption was significantly higher among pregnant women aged over 35 years (PR: 1.29; 95% CI: 1.03-1.63) and those with higher education (PR: 1.66; 95% CI: 1.11-2.50). Vegetable consumption was significantly higher among those with higher education (PR: 1.47; 95% CI: 1.00-2.15) and without government assistance (PR: 1.39; 95% CI: 1.08-1.77). Physical activity was more prevalent among women with an income greater than three minimum wages (PR: 2.38; 95% CI: 1.36-4.16). Furthermore, women with higher income had a lower prevalence of alcohol consumption (PR: 0.25; 95% CI: 0.07-0.85).

CONCLUSION: Unfavorable socioeconomic conditions are associated with risk behaviors among pregnant women with gestational diabetes, particularly alcohol consumption. Conversely, more favorable socioeconomic conditions are associated with health-protective factors, especially fruit and vegetable consumption and physical activity.

PMID:42090700 | DOI:10.1590/1983-1447.2026.20250179.en

Dental Press J Orthod. 2026 May 1;31(1):e2625219. doi: 10.1590/2177-6709.31.1.e2625219.oar. eCollection 2026.

ABSTRACT

INTRODUCTION: The treatment of Class III malocclusion has an important impact on facial and smile esthetics.

OBJECTIVE: To compare the facial profile attractiveness (FPA) of Class III malocclusion patients treated with and without premolar extractions.

MATERIAL AND METHODS: A retrospective sample of 39 Class III malocclusion patients was divided into two groups: Non-extraction group, composed of 20 patients (8 males, 12 females; mean age: 13.7 years); and the Extraction group, comprising 19 patients (9 males, 10 females; mean age: 15.0 years). Both groups were treated with orthodontic fixed appliances. Facial profile silhouettes were created from the pretreatment and posttreatment lateral cephalometric radiographs. The silhouettes were evaluated by 30 laypeople (20 males, 10 females; mean age: 32.2 years) and 29 orthodontists (13 males, 16 females; mean age: 48 years). The evaluators rated FPA using a scale ranging from 1 (least attractive) to 10 (most attractive). Intergroup comparisons of FPA between treatment protocols and evaluators were performed using Mann-Whitney tests. For intragroup comparisons of pre- and posttreatment stages, Wilcoxon tests were performed.

RESULTS: The extraction group was statistically more attractive in the pretreatment stage, when compared to the non-extraction group. Both groups showed no significant differences in the intragroup comparisons of pre- and posttreatment stages. Laypeople rated FPA significantly lower than orthodontists at both stages.

CONCLUSION: Class III malocclusion patients treated with and without extractions presented similar FPA at the posttreatment stage. No differences were observed for the FPA in the intragroup comparisons of pre- and posttreatment stages. Orthodontists were significantly less critical than laypeople.

PMID:42090698 | DOI:10.1590/2177-6709.31.1.e2625219.oar

Cad Saude Publica. 2026 May 1;42:e00128025. doi: 10.1590/0102-311XPT128025. eCollection 2026.

ABSTRACT

This study investigated the lack of access to water, sanitation, and hygiene (WASH) at Brazilian rural public elementary schools through a cross-sectional comparative study of the years 2011 and 2023. The distribution, temporal evolution, and determinant factors of this lack were assessed through descriptive analysis and binomial logistic regression, using the School Census of Basic Education as the main database. The results reveal persistent regional inequalities: the North region had the highest odds ratios for the absence of all WASH services in both years analyzed. Schools located on indigenous lands, with less than 10 students or with high dropout rates and low passing rates, had a greater likelihood of health exclusion. On the municipal level, the high proportion of the rural population and low Municipal Human Development Index – Income stood out as determinants. Despite occasional advances in access to water, setbacks in other services indicate stagnation or the worsening of inequalities. The results reveal that, after more than ten years, rural Brazil is still far from meeting the 4.a.1 target of the Sustainable Development Goals, which stipulates universal access to WASH in the school environment. By revealing the main institutional and regional obstacles, this study contributes to the planning of public policies that are more equitable and sensitive to the specificities of rural areas in Brazil.

PMID:42090694 | DOI:10.1590/0102-311XPT128025

Rev Assoc Med Bras (1992). 2026 May 1;72(2):e20251499. doi: 10.1590/1806-9282.20251499. eCollection 2026.

ABSTRACT

OBJECTIVE: In recent years, cesarean section rates have been increasing worldwide. Identifying changes in birth preferences during pregnancy is crucial for reducing cesarean section rates.

AIM: The aim of this study was to determine the Turkish validity and reliability of the Theory-Based Intention for cesarean section scale, originally developed by Naghibi et al.

METHODS: This methodological study was conducted with 300 pregnant women. Data were collected using the Introductory Information Form and the Theory-Based Intention for cesarean section scale. Analyses were performed using IBM SPSS 25.0 and AMOS 22.0. Language validity was evaluated through translation from the original Persian into Turkish as well as from English into Turkish. Content validity was calculated with nine experts using the Davis technique, and a pilot test was conducted with 30 pregnant women. Construct validity was assessed through Exploratory Factor Analysis and Confirmatory Factor Analysis. Internal consistency was examined with Cronbach’s Alpha coefficient and test-retest reliability.

RESULTS: Exploratory Factor Analysis revealed a five-factor structure with 24 items for the scale. According to Confirmatory Factor Analysis, the model fit indices indicated a good model fit. The Cronbach’s Alpha coefficient of the scale was 0.76. The item-total correlations and test-retest reliability of the scale were found to be high.

CONCLUSION: The Theory-Based Intention for cesarean section scale is a valid and reliable measurement tool for use among Turkish pregnant women.

PMID:42090689 | DOI:10.1590/1806-9282.20251499

Rev Assoc Med Bras (1992). 2026 May 1;72(2):e20251372. doi: 10.1590/1806-9282.20251372. eCollection 2026.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the effect of capsule invasion on recurrence and survival in breast cancer patients with axillary lymph node metastases.

METHODS: This retrospective study included 135 breast cancer patients with axillary lymph node involvement who underwent surgery between 2009 and 2018. The relationships between capsule invasion and various clinicopathological factors-including demographic parameters, tumor stage, surgical technique, histological type, number of involved lymph nodes, tumor size, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67 index-were analyzed using chi-square, Kaplan-Meier, and Fisher’s exact tests. Additionally, multivariate Cox regression analysis was performed to assess the independent prognostic value of capsule invasion for recurrence. A p<0.05 was considered statistically significant.

RESULTS: Capsular invasion was observed in 64 of 135 patients (47.4%). Recurrence occurred in six patients with capsule invasion compared to only one patient without capsule invasion. Multivariate Cox regression analysis, controlling for positive lymph node count, tumor size, grade, and receptor status, confirmed that capsule invasion was an independent predictor of recurrence [HR 3.45, 95%CI 1.12-10.65, p=0.032]. No significant association was found between tumor size and capsule invasion (p>0.05). During follow-up, 20 patients died (9 with and 11 without capsule invasion), with no significant difference in 5-year survival or mean survival time between groups (p=0.972, Kaplan-Meier analysis). Grading of capsular invasion showed a significant correlation with recurrence (p=0.026).

DISCUSSION: Although lymph node capsule invasion in breast cancer with axillary lymph node involvement does not significantly impact overall survival, it independently and significantly elevates the risk of recurrence, as demonstrated by multivariate analysis.

PMID:42090685 | DOI:10.1590/1806-9282.20251372

Rev Assoc Med Bras (1992). 2026 May 1;72(2):e20251303. doi: 10.1590/1806-9282.20251303. eCollection 2026.

ABSTRACT

OBJECTIVE: The use of social media is rapidly expanding worldwide. In parallel with the development of digital pathology, the use of digital social media platforms in the field of pathology has also increased. However, as with many other groups, pathologists still have some concerns about using social media. The aim of this study was to investigate the frequency and purposes of social media use among pathologists in their professional and personal lives.

METHODS: This study was conducted using an online survey designed via Google Forms and distributed among pathologists. The questionnaire collected data on participant demographics, the frequency and purposes of social media use, and its application in pathology education and practice.

RESULTS: A total of 124 pathologists participated in the study. All participants reported using social media in their daily lives. Among them, 101 (81.5%) indicated that they also used social media for pathology-related purposes. The platform considered most useful for pathology practice was X (formerly Twitter) (35.6%). Additionally, 98% of participants believed that social media could be beneficial for pathology education.

CONCLUSION: Despite potential sampling bias, our study indicates that among digitally connected pathologists in Turkey, social media, particularly X, is widely adopted as a valuable tool for professional education and practice.

PMID:42090684 | DOI:10.1590/1806-9282.20251303

Rev Assoc Med Bras (1992). 2026 May 1;72(2):e20251085. doi: 10.1590/1806-9282.20251085. eCollection 2026.

ABSTRACT

OBJECTIVE: The aim of this study was to determine the relationship between satisfaction with prenatal care and labor satisfaction and perception of labor.

METHODS: The cross-sectional and correlational study was conducted in the obstetrics ward of a public hospital. The population of the study consisted of women who gave birth in this hospital, while the sample consisted of 200 women. The data were collected face-to- face using the “Personal Information Form, Prenatal Care Satisfaction Scale, Birth Satisfaction Scale, and Mother’s Perception of Childbirth Scale.”

RESULTS: It was found that 56% of the mothers who participated in the study received prenatal care from a midwife/nurse, 60.3% received prenatal care at a Family Health Center, and the mean total scores of the mothers were 71.69±9.67, 73.66±5.48, and 102.56±5.26 on the Prenatal Care Satisfaction Scale, Mother’s Perception of Childbirth Scale, and Birth Satisfaction Scale, respectively. In addition, a positive and significant correlation was found between the mean scores of the women on the Prenatal Care Satisfaction Scale and the mean scores on the Mother’s Perception of Childbirth Scale and Birth Satisfaction Scale.

CONCLUSION: In the study, it was concluded that as women’s prenatal care satisfaction levels increased, their birth satisfaction and positive birth perception also increased.

PMID:42090683 | DOI:10.1590/1806-9282.20251085

Braz Dent J. 2026 May 1;37:e256778. doi: 10.1590/0103-644020266778. eCollection 2026.

ABSTRACT

This study was a parallel, double-blind, randomized clinical trial that aimed to evaluate the effect of silver diamine fluoride (SDF) on the prevention of dental caries in the first permanent molars of children. A total of 68 students aged 6 to 9 years from a public school in Diamantina, Brazil, participated. All children were classified as high caries risk and had at least one fully erupted molar without restorations or sealants. The participants were randomly divided in a 1:1 ratio to receive either SDF or resin sealant. The main outcome was the incidence of new carious lesions after 24 months. Secondary outcomes included plaque accumulation, gingival bleeding, oral health-related quality of life (OHRQoL, CPQ-8-10), caregiver satisfaction, and discomfort reported by the children using the Wong-Baker scale. Sociodemographic and health information were collected using questionnaires, dietary diaries, and clinical examinations in accordance with ICDAS-II criteria. Statistical analysis was performed using SPSS 22.0, employing Chi-square, Mann-Whitney, and Wilcoxon tests. Most families had low incomes, and mothers were usually responsible for the children’s daily care. After 2 years, the SDF group showed a significant reduction in plaque compared with baseline, whereas the sealant group showed a small, non-significant increase. No significant difference in gingival bleeding was observed between groups. Both interventions were well tolerated, although the dark staining of the SDF-treated teeth was clearly visible. In conclusion, SDF demonstrated good preventive performance and acceptance among children at.

PMID:42090679 | DOI:10.1590/0103-644020266778

Sao Paulo Med J. 2026 May 1;144(2):e20253337. doi: 10.1590/1516-3180.2025.3337.13022026. eCollection 2026.

ABSTRACT

BACKGROUND: Frailty in older adults is a multifactorial geriatric syndrome associated with inflammation, malnutrition, and hematological decline. Objective and easily applicable laboratory-based indices may complement clinical frailty assessment by providing rapid and low-cost screening tools, particularly in primary care and resource-limited settings.

OBJECTIVES: To develop a simple laboratory-based frailty screening index (FINE, Frailty Index for the Elderly) using C-reactive protein (CRP), albumin, hemoglobin, and sex, and to evaluate its association with the Clinical Frailty Scale (CFS) in older adults.

DESIGN AND SETTING: A retrospective descriptive study conducted using electronic health records of individuals aged 80 years and older.

METHODS: Data from 322 older adults were analyzed. Their FINE scores were calculated by assigning 0 or 1 point to CRP, albumin, hemoglobin, and sex based on clinically accepted reference thresholds, yielding a total score ranging from 0 to 4. Frailty was assessed using pre-recorded CFS scores. Associations between FINE scores, CFS, and individual biomarkers were examined. The screening performance was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS: The mean age of participants was 84.9 ± 4.0 years, and 55.6% were female. The prevalence rate of frailty was 46.6%. FINE scores exhibited a positive correlation with CFS and CRP levels, and a negative correlation with albumin and hemoglobin levels (p < 0.005). ROC analysis demonstrated a statistically significant but moderate discriminatory ability for frailty (area under the curve = 0.642; 95% confidence interval: 0.5820.703). At a cut-off value of ≥ 0.5, FINE scores demonstrated high sensitivity (89.3%) but low specificity (22.1%).

CONCLUSION: The FINE score is a simple, rapid, and low-cost laboratory-based frailty screening tool that is significantly associated with clinical frailty and key biological processes underlying frailty. Although low specificity limits its use as a diagnostic instrument, it may serve as a practical first-step screening approach in primary care and resource-limited settings. Further multicenter prospective studies are required to validate these findings.

PMID:42090677 | DOI:10.1590/1516-3180.2025.3337.13022026