Tag: nevin manimala

Sci Rep. 2025 May 4;15(1):15582. doi: 10.1038/s41598-025-99538-z.

ABSTRACT

Bacterial meningitis is a significant public health concern, with over 1.2 million cases reported globally each year. Rwanda is at increased risk of meningitis outbreaks due to its proximity to countries that lie in the meningitis belt. Rwanda has been conducting surveillance and recording meningitis outbreak cases across the country since 2012. We evaluated the meningitis surveillance system at Kibogora Level Two Teaching hospital, Nyamasheke district of Rwanda to assess whether the surveillance objectives were being met. The study was cross-sectional, using purposive sampling to select healthcare providers participating in the meningitis surveillance. Rwanda’s bacterial meningitis data from 2017 to 2021 was collected from clinical registers and Rwanda’s electronic integrated disease surveillance system (eIDSR) from Kibogora Level Two Teaching Hospital catchment area, Nyamasheke district, Rwanda. The study area was chosen because a meningitis outbreak was recorded in the area and its bordering country namely Democratic of Republic of Congo (DRC) prior to the current study period. Information on the participant’s demographics, occupation, training, professional experience, and their perception on the surveillance system were gathered using a structured questionnaire. Meningitis surveillance systems attributes including usefulness, acceptability, and flexibility were assessed and categorized as poor (< 50% score), reasonable (50-69%), good (70-90%), or excellent (> 90%) in reference to the study conducted on the evaluation of the meningitis surveillance system in Luanda Province, Angola in March 2017. Data collected from clinical registers and eIDSR were used to assess core functions of the meningitis surveillance system including accuracy in detection of cases, laboratory confirmation of cases, and availability of evaluation reports. Descriptive statistics were analyzed using Microsoft Office Excel. Thirty-one healthcare providers working on meningitis surveillance in the Kibogora Level Two Teaching Hospital were interviewed. During the period under evaluation, 48 suspected cases of meningitis were identified; 43 (90%) met the surveillance case definition, and only 10 (21%) were reported to eIDSR (completeness). Attributes such as flexibility scored good while stability and acceptability scored reasonable. Out of 48 suspected meningitis cases, only 2 (4%) samples were collected from patients and sent to the hospital laboratory for analysis. This study found a good knowledge level of the meningitis surveillance system among healthcare workers; however, the system’s core functions, such as notification rate and laboratory confirmation were found to have gaps. The notification rate could be improved by conducting regular refresher courses for healthcare workers supporting surveillance system. Moreover, MoH could enhance the implementation of a national policy requiring mandatory CSF sample testing to confirm pathogens for all suspected cases. Future studies should explore performance-based incentives to improve reporting completeness. Rwanda’s experience could provide insights for other low-resource settings facing similar surveillance challenges.

PMID:40320439 | DOI:10.1038/s41598-025-99538-z

Sci Rep. 2025 May 4;15(1):15603. doi: 10.1038/s41598-025-00466-9.

ABSTRACT

The intestinal microbiota, in terms of both composition and functioning, exerts a significant influence on the human body. Disturbed microbiota is a common occurrence in the context of numerous diseases. The available evidence increasingly points to a correlation between this condition and the development of prostate diseases, including benign prostatic hyperplasia and prostate cancer. 16 S sequencing of the V3-V4 region was performed and then evaluated alpha and beta diversity of the faeces microbiota of healthy (control group, N = 81) and BPH patients (study group, N = 76). The exploration of enterotypes involved the application of the Dirichlet-Multinomial model, executed for selecting community types. The study revealed no statistically significant difference in alpha diversity between the control group and the group of patients diagnosed with BPH. However, a significant difference was observed in beta diversity (Permanova test: F-value = 5.56, p-value < 0.001). The identification of enterotypes revealed significant differences between the healthy male cohort and those diagnosed with BPH (p = 0.035). In the cohort of men with BPH, the most prevalent was enterotype 3, characterized by a predominance of Blautia, Bacteroides, and Streptococcus. The occurrence of enterotype 3 was associated with an increased likelihood of BPH, exceeding threefold that of enterotype 1 (OR = 3.24). These findings suggest that alterations in the gut microbiota, particularly the presence of enterotype 3, may serve as a microbiological pattern associated with BPH.

PMID:40320423 | DOI:10.1038/s41598-025-00466-9

Sci Rep. 2025 May 4;15(1):15607. doi: 10.1038/s41598-025-00026-1.

ABSTRACT

To address the low repeatability and accuracy of traditional technologies for testing the human somatosensory system, this work presents a novel mechatronic testbed. The testbed allows for the delivery of mechanical and thermal stimuli with a high spatial resolution, enabling continuous or discrete stimulation with a small fixed area and in a single experimental session. The testbed was employed to identify the mechanical/thermal innocuous and painful thresholds and the human ability to distinguish the nature of a painful stimulus, on both the hand and the forearm of 12 healthy volunteers. The results demonstrated the capability of the developed testbed to produce a range of forces that can induce different sensations (touch or pain). We found a statistical difference between the innocuous and painful thresholds, regardless of the tested anatomical spot. In this paper, a small thermal stimulation tip was appositely selected to study the reaction to a focused thermal stimulus that has been poorly investigated so far. The results highlighted a statistically significant difference between the two stimulated sites for the cool sensation and the hot pain. Moreover, the painful recognition task was sped up by the use of the developed testbed, which allowed a more fair comparison among the applied stimuli, increasing the accuracy, repeatability, and consistency when compared to the state-of-the art.

PMID:40320402 | DOI:10.1038/s41598-025-00026-1

Sci Rep. 2025 May 4;15(1):15592. doi: 10.1038/s41598-025-00222-z.

ABSTRACT

Small cell lung cancer (SCLC) is a highly malignant lung cancer subtype with a dismal prognosis and limited treatment options. This study aimed to identify new prognostic molecular biomarkers for SCLC and explore their immune-related implications for treatment strategies. We analyzed 200 SCLC samples via whole-exome sequencing (WES) and 313 samples by targeted sequencing. A smoking-related SBS4 mutational signature was linked to poorer prognosis and lower tumor mutational burden (TMB), while the APOBEC-mediated SBS13 signature was associated with better prognosis and higher TMB. We identified a molecular subtype with the worst outcomes and lowest TMB in both cohorts. Among 38 high-frequency mutated genes associated with SCLC prognosis, only UNC13A mutations were beneficial. Patients with UNC13A mutations had favorable immune infiltration and tumor immunogenicity. Additionally, TP53 splice site mutations were related to the worst survival outcomes. In conclusion, we discovered new molecular biomarkers for SCLC prognosis. Our findings on their immunological characteristics offer insights for developing novel SCLC treatment strategies.

PMID:40320401 | DOI:10.1038/s41598-025-00222-z

Sci Rep. 2025 May 4;15(1):15613. doi: 10.1038/s41598-025-00288-9.

ABSTRACT

Good sleep quality is crucial for health and body equilibrium, particularly during pregnancy, where changes in sleep are influenced by mechanical and hormonal factors. Poor sleep can hinder daily activities and lead to adverse pregnancy outcomes. Data on sleep quality are scarce in low and middle-income countries such as Ethiopia. Hence, this study aimed to determine the magnitude of sleep quality and its associated factors among pregnant mothers in Bahir Dar City, northwest Ethiopia. A facility-based cross-sectional study was conducted with 367 randomly selected pregnant women. All pregnant women who attended public health facilities in Bahir Dar City from November 1st to December 30, 2022 were included except who were critically ill and aged less than 18 years. The data were collected through face-to-face interviews. Sleep quality was assessed by using the Pittsburgh Sleep Quality Index (PSQI). Stata v14 was used for data analysis. A binary logistic regression model was used to identify factors associated with poor sleep quality. Statistical significance was set at p < 0.05. The prevalence of poor sleep quality was 55.04%. In the multivariable analysis, older maternal age (AOR = 3.62), third trimester (AOR = 2.83), multigravidas (AOR = 2.55), low hemoglobin (AOR = 1.92), and coffee consumption (AOR = 2.19) were associated with poor sleep quality. More than half of pregnant women had poor sleep quality. Women aged ≥ 30 years, 3rd trimester, multigravidas, anemic women, and coffee consumption during pregnancy were factors associated with poor sleep quality. The concerned body should pay attention to improving Hgb level and iron/folate supplementation and reduce coffee intake in pregnant women to improve maternal sleep quality during pregnancy.

PMID:40320398 | DOI:10.1038/s41598-025-00288-9

Med J Aust. 2025 May 5;222(8):403-411. doi: 10.5694/mja2.52649.

ABSTRACT

OBJECTIVES: To investigate the type and frequency of incidental findings in people at high risk of lung cancer who undergo baseline low-dose computed tomography (LDCT) lung cancer screening in Australia and Canada.

STUDY DESIGN: Prospective observational study; sub-study of the single-arm International Lung Screen Trial (ILST) lung cancer screening study.

SETTING, PARTICIPANTS: Australian and Canadian people enrolled in the ILST, 25 August 2016 – 21 November 2020; inclusion criteria: aged 50-80 years, active smoking history, and high risk of lung cancer (estimated six-year lung cancer risk of 1.51% or more, based on the PLCO_m2012 risk prediction model; or a smoking history of 30 pack-years or more). Initial LDCT screening was undertaken at one of five participating hospitals in Australia and one in Canada.

MAIN OUTCOME MEASURES: Prevalence of incidental findings during baseline LDCT lung cancer screening (using a research checklist), by country, classified by experienced radiologists as requiring or not requiring clinical follow-up; reporting of incidental findings in clinical reports for treating physicians (two Australian sites only).

RESULTS: A total of 4403 participants completed baseline LDCT screening at the six participating hospitals. The mean age (64-65 years) and the proportions of participants who currently smoked (47-55%) were similar at all six sites; the proportion of female participants was larger in Sydney (52%) and Vancouver (51%) than the other sites (39-44%). At least one incidental finding was made during baseline LDCT screening of 3225 people (72.8%); findings in 454 people (10.3%) required clinical follow-up. The most frequent incidental findings were coronary artery calcification (3022 of 4380 participants with recorded results, 69.0%) and emphysema (2378 of 4401, 54.0%). Marked differences between the Australian and Canadian sites in the prevalence of incidental findings were noted, and also between the two Australian sites in their communication of incidental findings in clinical screening reports.

CONCLUSION: Incidental findings during lung cancer screening were frequent, and clinical reporting of these findings was inconsistent. When LDCT lung cancer screening is introduced in Australia, a standardised reporting template should be used to provide clear guidance about the clinical significance of such findings.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT02871856 (prospective, 18 August 2016).

PMID:40320382 | DOI:10.5694/mja2.52649

Int J Gynecol Cancer. 2025 Apr 11;35(6):101821. doi: 10.1016/j.ijgc.2025.101821. Online ahead of print.

ABSTRACT

OBJECTIVE: Ovarian cancer surgery and the complexity of the procedure may be measured with the standardized Aletti score. The main objective of this study was to establish the influence of surgical complexity using the Aletti score on disease-free survival and overall survival.

METHODS: A retrospective observational study was conducted in a reference gynecologic oncology department, including advanced ovarian cancer patients, newly diagnosed who underwent a primary debulking surgery or interval debulking surgery between January 2010 and December 2019 (stage IIB-IV International Federation of Gynecology and Obstetrics classification), and epithelial histology. Incomplete medical records, loss to follow-up patients, and borderline histologies were excluded. Survival analysis and multivariate analysis were performed.

RESULTS: A total of 399 patients were included in the study. Regarding Aletti score complexity, no differences were observed in disease-free survival (median: 25 vs 24 months, p = .5) or overall survival (median: 56 vs 49 months, p = .6). Complete cytoreduction was associated with better disease-free survival (median: complete 26 vs optimal 14 vs sub-optimal 9 months, p < .0001) and overall survival (p < .0001). Furthermore, primary debulking surgery showed statistically better disease-free survival (median: 25 vs 16 months, p < .0001) and overall survival (median: 72 vs 38 months, p < .0001) compared to interval debulking surgery. The multivariable analysis showed that disease-free survival, overall survival, International Federation of Gynecology and Obstetrics classification, CA125 level at diagnosis, cytoreduction classification achieved after surgery, and the Clavien-Dindo complications did not significantly associate with the Aletti score.

CONCLUSIONS: Disease-free survival and overall survival were not influenced by the surgical complexity in patients undergoing cytoreduction after the first diagnosis of advanced ovarian cancer. A higher Aletti score was not associated with a higher rate of complications.

PMID:40319539 | DOI:10.1016/j.ijgc.2025.101821

Braz J Phys Ther. 2025 May 3;29(4):101226. doi: 10.1016/j.bjpt.2025.101226. Online ahead of print.

ABSTRACT

BACKGROUND: Therapeutic exercise (TE) is the only intervention with strong recommendation for fibromyalgia. However, there is controversy as to which type of exercise is the most beneficial.

OBJECTIVE: To determine which TE approach is the most effective in reducing pain intensity in women with fibromyalgia.

METHODS: A systematic review was performed with a network meta-analysis (NMA). Six databases were searched from inception until January 2024. Randomized controlled trials (RCTs) evaluating the effects of TE on pain intensity were included in women with fibromyalgia. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The size of the effect and the clinically important difference were determined in the short-term (≤3 months) and long-term (>3 months).

RESULTS: Sixty-one studies were identified, of which 51 were included in the quantitative synthesis (n = 2873). Fifteen TE interventions and eight comparison interventions (comparators) were identified. Aquatic exercise (p-score: 0.8713) was found to provide best benefits in the short-term and resistance training in the long-term (p-score: 0.9749). Statistically significant differences were found in favor of aquatic exercise, Pilates, qigong, resistance training, virtual reality, mixed exercise, and aerobic exercise (in the short-term) and in favor of resistance training, dance, functional training, aquatic exercise, virtual reality, and aerobic exercise (in the long-term) compared to usual care.

CONCLUSION: With a moderate level of evidence, our NMA shows that, in the short-term, aquatic exercise is the most effective TE intervention to reduce pain intensity in women with fibromyalgia, while resistance training is the most effective in the long-term. More RCTs are needed to strengthen these findings.

PMID:40319533 | DOI:10.1016/j.bjpt.2025.101226

J Forensic Leg Med. 2025 Apr 15;113:102856. doi: 10.1016/j.jflm.2025.102856. Online ahead of print.

ABSTRACT

BACKGROUND: The International Classification of Diseases (ICD-11), developed by the WHO, is widely used to code and classify causes of death. While it is a suitable system for clinical data, it is not tailored for forensic diagnoses. This article explores the basic principles and methods for classification of cause of death in a forensic setting. An in-house Dutch coding system, the FDC system, was developed in the Netherlands.

PURPOSE: To determine the validity and applicability of the FDC system.

METHODS: The FDC system was used to code 138 deaths based on the forensic autopsy reports of the Netherlands Forensic Institute. This was performed by three investigators (one forensic pathologist and two forensic physicians, all of whom are forensic experts) to compute the inter-investigator agreement using Krippendorff’s alpha (kalpha) statistics. To measure the intra-investigator agreement, 46 cases per investigator (for each investigator different cases) were presented twice in random order. The coding system has five parameters: Main category, Subcategory, Other contributing factor category, Mode of death category, and Certainty of death category.

RESULTS: The Krippendorff’s alphas (kalphas) for the inter-investigator agreement were as follows: Main category 0.91, Subcategory 0.74, Mode category 0.49 and Certainty category 0.55. Inter-investigator agreement showed high kalpha scores for both Main category and Subcategory. There was a good intra-investigator agreement. The kalphas were as follows: Main category 0.95, Subcategory 0.87, Mode category 0.65, and Certainty category 0.78.

CONCLUSION: The FDC system is an in-house Dutch system that is useful for coding causes of death from a forensic perspective. This system could make the notation of forensic pathologists and forensic physicians less ambiguous, which could improve the understanding of cases by professionals such as public prosecutors, lawyers and judges who have to make decisions based on autopsy reports. In the future, this system could also be used in forensic medicine by forensic physicians and for (forensic) mortality reporting in public health statistics.

PMID:40319532 | DOI:10.1016/j.jflm.2025.102856

Orv Hetil. 2025 May 4;166(18):710-716. doi: 10.1556/650.2025.33287. Print 2025 May 4.

ABSTRACT

Bevezetés: A gerincfájdalmak, radiculopathiák hátterében gyakran degeneratív eltérések állnak, melyek gyakori javallatai a gerinc-MR-képalkotó vizsgálatoknak. A porckorong-degeneráció, a porckorong kitüremkedés/sérv, a gerinccsatorna-szűkület és a kisízületi arthrosis, valamint a csigolyákat, spinalis teret érintő kórfolyamatok kimutatása MR-vizsgálatot igényelhet. Célkitűzés: Bizonyos állapotok egyértelműen indokolják a gerinc MR-rel végzett leképezését, de vajon minden esetben megalapozott-e az MR-vizsgálat iránti igény? Módszer: Kórházunkban 2023-ban 2105 gerinc-MR-vizsgálat történt, melyeket egyesével értékeltünk a beutalás szempontjai és az eredmények áttanulmányozása alapján. Eredmények: Kórházunkban gerinc-MR-vizsgálatra beutalót különféle területek szakorvosai adtak. Az esetek 87%-ában ezek hátterében nem igazolódott neurológiai indok, és a képalkotók sem mutattak klinikailag releváns, műtéti beavatkozást igénylő eltérést. Mindezek következményeként a sok „felesleges” vizsgálat miatt a várólistánk több hónapra nyúlt, valamint sok esetben a daganatos betegekre vonatkozó „14 napos jogszabály” is sérült. Megbeszélés, következtetés: A beutaló orvosokat arra kell ösztönözni, hogy kövessék a szakma lefektetett szabályait és iránymutatásait, hogy ezáltal is csökkenthetők legyenek a várólisták és az ellátás költségei, továbbá könnyebben biztosítható legyen a valóban sürgős betegek időben történő ellátása. Orv Hetil. 2025; 166(18): 710–716.

PMID:40319466 | DOI:10.1556/650.2025.33287