Tag: nevin manimala

Sci Rep. 2025 Aug 3;15(1):28326. doi: 10.1038/s41598-025-13733-6.

ABSTRACT

A growing body of literature supports the association between ambient particulate pollution and the risk of type 2 diabetes (T2DM). Both issues are particularly relevant in Italy. This study investigates the relationship between T2DM and exposure to PM_2.5 and PM₁₀ in Italian municipalities from 2013 to 2021. Data on T2DM were provided by the Italian Association of Diabetologists (AMD), representing the only national outpatient dataset not based on self-reported information. Air pollution data, sourced from the Italian Institute for Environmental Protection and Research, ISPRA, were summarized using the population-weighted exposure (PWE) indicator. Both datasets were made available through a dedicated research agreement. Random effects models and non-parametric methods were applied to assess the association between air pollution and T2DM. Results indicate a statistically significant relationship, particularly between T2DM and PM2.5. T2DM incidence rates were significantly negatively associated with time (coefficient = – 0.07961, p < 0.01), indicating a decreasing trend over time. After adjusting for other covariates, PM₁₀ population-weighted exposure was not significantly associated with incidence rates (coefficient = – 0.00057, p = 0.58). On the other hand, increases in the ratio of PM_2.5 to PM₁₀ (pwratio) were significantly positively associated with increases in T2DM incidence rates (coefficient = 0.52304, p < 0.01) at the municipal level. T2DM prevalence proportions were significantly positively associated with time (coefficient = 0.01749, p < 0.01), suggesting an increasing trend over time. PM₁₀ was significantly negatively associated with prevalence proportions (coefficient = – 0.00298, p = 0.03), while increases in pwratio were significantly positively associated with increases in prevalence proportions (coefficient = 0.18724, p < 0.01). Thus, municipalities with a higher share of PM_2.5 within the same level of PM₁₀, tended to show higher T2DM prevalence proportions and incidence rates, consistent with the spatial distribution of air pollution and disease burden observed across Italy.

PMID:40754624 | DOI:10.1038/s41598-025-13733-6

Sci Rep. 2025 Aug 3;15(1):28304. doi: 10.1038/s41598-025-13087-z.

ABSTRACT

The efficient formulation of drilling fluids is critical for maintaining stability and performance in demanding wellbore environments. In this study, a novel nanocomposite material (TiO₂/Saponin/Zr) was synthesized and introduced into drilling fluid formulations to enhance rheological behavior, filtration control, and thermal stability. The synthesis involved sol-gel methods, FTIR, TGA, and SEM analyses, confirming the material’s successful functionalization and nanoscale structure. Rheological measurements demonstrated significant improvements in viscosity and shear stress with nanoparticle concentrations up to 500 ppm, where the optimal performance was achieved. Filtration tests revealed reductions in fluid loss by up to 50%, ensuring better wellbore stability. Statistical modeling with the Bingham Plastic and Herschel-Bulkley approaches revealed superior predictability for these nanocomposite-enhanced fluids. Overall, this innovative nanocomposite provides a promising avenue for addressing challenges in modern drilling operations, offering technical and operational benefits.

PMID:40754607 | DOI:10.1038/s41598-025-13087-z

Eur J Orthop Surg Traumatol. 2025 Aug 3;35(1):337. doi: 10.1007/s00590-025-04470-7.

ABSTRACT

PURPOSE: Anterior cruciate ligament (ACL) injury is a common sports-related injury that often requires surgical intervention. The two main types of grafts used in ACL reconstruction are autografts and allografts. Two types of transplants have their own advantages in different aspects, so the choice of graft type is a matter of ongoing debate among orthopedic surgeons. The purpose of this systematic review and meta-analysis is to compare the results of ACL reconstruction using allograft versus autograft.

METHODS: The Embase and PubMed databases were searched for clinical trial literature from January 1, 2000, to July 19, 2023, which met the individual inclusion criteria, for a meta-analysis of objective and subjective outcomes of the knee joint. Using random effects model, risk of bias was assessed using the Cochrane Collaboration’s tools.

RESULTS: Thirteen studies and total of 1299 patients were included in the analysis. The pooled mean difference (MD) of subjective IKDC score was 2.14 (95% CI:1.43-2.85). The pooled MD of Lysholm score was 0.38 (95% CI:-1.25-2.02). The pooled MD of Tegner score was 0.23 (95% CI:0.03-0.43). The pooled relative risk (RR) of Lachman test was 1.32 (95% CI:0.95-1.82). The pooled RR of pivot shift test was 1.12 (95% CI:1.00-1.25). The pooled RR of objective IKDC was 1.03 (95% CI:1.01-1.05). In general, statistically significant differences in favor of autograft were observed for Subjective International Knee Documentation Committee score, Tegner score, pivot shift test and Objective International Knee Documentation Committee score, as for the Lysholm score and Lachman test there is no statistical differences between the two.

CONCLUSION: From a majority of the outcome measures, autografts appear to have a slightly better effect compared to allografts. However, these slight differences in scores may not be reflected in clinical outcomes, indicating that there is not much superiority or inferiority between the two from the perspective of clinical outcomes. Therefore, in other fields such as humanities and economics, they are important factors for doctors to make choices in clinical practice.

PMID:40754602 | DOI:10.1007/s00590-025-04470-7

Echo Res Pract. 2025 Aug 4;12(1):19. doi: 10.1186/s44156-025-00086-z.

ABSTRACT

BACKGROUND: Transthoracic echocardiography (TTE) is used to assess aortic stenosis (AS) severity and track disease progression. As the field moves to study medical therapies to halt disease progression, reliable non-invasive imaging markers that are sensitive to small changes in disease progression are needed to enable efficient trial designs. The signal-to-noise ratio of commonly obtained TTE-based measures of progressive (non-severe) AS severity is unknown.

METHODS: This is a retrospective study of TTEs done at a tertiary referral centre (Tufts Medical Center, Boston MA). A cohort of patients with progressive AS who had two TTEs done within 30 days (in the absence of valve intervention) and a cohort of progressive AS patients with TTEs ≥ 1 year apart, also without valvular intervention, were assembled. Limits of agreement (LOA) and intraclass correlation (ICC) were calculated for aortic valve area (AVA) by continuity equation, peak velocity, and mean gradient. Cohen’s d-statistic (d) was calculated for each hemodynamic assessment and a composite marker to assess sensitivity for detecting disease progression normalised to measurement variability.

RESULTS: The reproducibility cohort included 24 patients. The progression cohort included 35 patients. The median age was 70 years (interquartile range [IQR] 13). 22 patients (37.3%) were female. In the progression cohort, the median time between TTEs was 2.2 years (IQR 3.1 years). In the reproducibility cohort, AVA LOA were -0.7 to 0.8, ICC = 0.61; peak velocity LOA were -149.0 to + 126.7, ICC = 0.29; and mean gradient LOA were -16.2 to 12.2, ICC = 0.06. The d-statistic for annualised change in AVA was -0.29, the d-statistic for annualised change in maximum velocity was 0.46, the d-statistic for mean gradient was 0.55. The d-statistic for a composite, including all three hemodynamic markers, was 0.45.

CONCLUSIONS: Standard TTE markers of AS severity have variable sensitivity for detecting AS progression. For patients with progressive (non-severe) AS, mean gradient has the highest signal-to-noise ratio and may be the most reliable TTE-based assessment of disease progression.

PMID:40754590 | DOI:10.1186/s44156-025-00086-z

J Health Popul Nutr. 2025 Aug 3;44(1):275. doi: 10.1186/s41043-025-01032-9.

ABSTRACT

BACKGROUND: Magnesium, an essential dietary trace element, plays a crucial role in numerous physiological processes, and its deficiency has been associated with the development of hyperlipidemia. However, its potential to predict long-term outcomes and inform risk stratification in hyperlipidemic patients remains underexplored.

METHODS: This retrospective cohort study introduces the magnesium depletion score (MgDS), a novel index for quantifying magnesium deficiency, and investigates its association with mortality outcomes in individuals with hyperlipidemia. Data from 12,592 participants in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were analyzed. Advanced statistical methods, including weighted Cox proportional hazards models, restricted cubic spline (RCS) analysis, Kaplan-Meier survival curves, and receiver operating characteristic (ROC) analysis, were employed to assess the association between MgDS and mortality risks.

RESULTS: The results indicate that higher MgDS is significantly associated with increased risks of both all-cause and cardiovascular mortality in individuals with hyperlipidemia, even after adjusting for confounders. Subgroup analyses identified prediabetes, smoking, and alcohol consumption as significant modifiers of this association. RCS analysis confirmed a linear relationship between MgDS and mortality, further supporting its value as a reliable predictor of long-term outcomes. ROC analysis demonstrated the potential of MgDS as an independent tool for predicting mortality at 1, 3, and 5 years. Notably, high MgDS levels in hyperlipidemic individuals with binge drinking habits were associated with significantly higher mortality risks.

CONCLUSIONS: These results establish MgDS as a promising biomarker for mortality risk stratification in patients with hyperlipidemia. This novel index offers important insights for clinical practice and could facilitate the development of tailored management strategies, particularly for high-risk hyperlipidemia populations, to mitigate long-term health risks.

PMID:40754582 | DOI:10.1186/s41043-025-01032-9

Light Sci Appl. 2025 Aug 4;14(1):259. doi: 10.1038/s41377-025-01914-x.

ABSTRACT

The photo-kinetics of fluorescent molecules have enabled the circumvention of the far-field optical diffraction limit. Despite its enormous potential, the necessity to label the sample may adversely influence the delicate biology under investigation. Thus, continued development efforts are needed to surpass the far-field label-free diffraction barrier. The statistical similarity or finite coherence of the scattered light off the sample in label-free mode hinders the application of existing super-resolution methods based on incoherent fluorescence imaging. In this article, we present physics and propose a methodology to circumvent this challenge by exploiting the photoluminescence (PL) of silicon nitride waveguides for near-field illumination of unlabeled samples. The technique is abbreviated EPSLON, Evanescently decaying Photoluminescence Scattering enables Label-free Optical Nanoscopy. We demonstrate that such an illumination has properties that mimic the photo-kinetics of nano-sized fluorescent molecules, i.e., such an illumination permits incoherence between the scattered fields from various locations on the sample plane. Thus, the illumination scheme enables the development of a far-field label-free incoherent imaging system that is linear in intensity and stable over time, thereby permitting the application of techniques like structured illumination microscopy (SIM) and intensity-fluctuation-based optical nanoscopy (IFON) in label-free mode to circumvent the diffraction limit. In this proof-of-concept work, we observed a two-point resolution of $~$ 180 nm on super-resolved nanobeads and resolution improvements between 1.9× to 2.8× over the diffraction limit, as quantified using Fourier Ring Correlation (FRC), on various biological samples. We believe EPSLON is a step forward within the field of incoherent far-field label-free super-resolution microscopy that holds a key to investigating biological systems in their natural state without the need for exogenous labels.

PMID:40754581 | DOI:10.1038/s41377-025-01914-x

Trop Dis Travel Med Vaccines. 2025 Aug 4;11(1):24. doi: 10.1186/s40794-025-00260-5.

ABSTRACT

INTRODUCTION: Enteric diseases are a leading cause of mortality in developing countries, yet are highly preventable. Typhoid vaccines remain underutilized, and diagnostic capacity constraints impede treatment and prevention. Wastewater monitoring could provide a more accurate picture of disease burden if detection and quantification of Salmonella Typhi in wastewater are advanced. To motivate why countries should invest to improve wastewater testing methods, we conducted a cost-benefit analysis, quantifying the value this approach could yield.

METHODS: We estimated benefits that could accrue if wastewater data informed the early launch of a theoretical typhoid vaccine campaign in Cox’s Bazar, Bangladesh. After empirically estimating the lead-time advantage of wastewater data over clinical data to flag case upticks, we simulated changes in case counts from a 1- to 14-day early campaign launch, using ordinary differential equation modeling. We quantified benefits resulting from averted cases (from preserved caregiver time, school days, and wages), hospitalizations (from savings to public funds), and deaths (using the value of statistical life). We then calculated how cumulative benefits, costs, and the ratio of the two varied by campaign launch timing scenario over a five-year period.

RESULTS: Wastewater concentrations of Salmonella Typhi upticked up to 13 days before case counts. Cumulative benefits varied by year and launch timing. With a 13-day early launch, every $100 spent on wastewater monitoring could yield $295 in societal benefits by year 5. Cumulative benefits roughly equaled cumulative costs with a 5-day early launch and outweighed costs when the campaign was launched even earlier.

CONCLUSION: If wastewater data can be advanced to reliably provide early warnings of new typhoid outbreaks, governments could reap large benefits that more than justify spending on program implementation. Our findings could generalize to other high-aid countries that, like Bangladesh, experience routine enteric disease outbreaks and have strong operational networks.

PMID:40754580 | DOI:10.1186/s40794-025-00260-5

BMC Med. 2025 Aug 4;23(1):453. doi: 10.1186/s12916-025-04249-x.

ABSTRACT

BACKGROUND: With respiratory syncytial virus vaccines recently approved for use among older adults, country-level respiratory syncytial virus (RSV) disease burden estimates are needed to inform local RSV immunisation strategy. We aimed to estimate country-level RSV hospitalisation burden in older adults in Europe.

METHODS: We compiled data on RSV hospitalisation burden in adults aged ≥ 60 years in Europe from published studies (systematic review: PROSPERO CRD42024516945), surveillance data, and unpublished data from international collaborators. We adjusted for diagnostic testing, clinical specimens, and case definitions through statistical modelling techniques and generated country-level hospitalisation rate estimates; for countries with no available data, we developed an ensemble model to predict RSV hospitalisation rates. We also estimated RSV in-hospital case fatality ratio (hCFR) for countries with available data.

RESULTS: We included 14 studies (3 unpublished studies). The adjusted RSV-associated hospitalisation rates were overall 2.2 to 6.4 times higher than unadjusted estimates. Among 5 countries with available data, adjusted annual RSV hospitalisation rates ranged from 193/100,000 person-years in the Netherlands (95% confidence interval [CI]: 125-304) and Finland (141-274) to 414/100,000 in Denmark (322-514). The RSV hospitalisation rates predicted by the ensemble model in 23 additional countries ranged from 223/100,000 to 317/100,000 person-years. RSV hCFR ranged from 6.73% (4.63-9.69) in Spain to 10.14% (4.91-19.79) in Switzerland.

CONCLUSIONS: This study addresses knowledge gaps in RSV hospitalisation burden among older adults in Europe while highlighting the importance of adjusting for RSV case under-ascertainment. These findings might be relevant for country’s considerations of RSV immunisation strategies for older adults.

PMID:40754579 | DOI:10.1186/s12916-025-04249-x

BMC Med. 2025 Aug 4;23(1):454. doi: 10.1186/s12916-025-04257-x.

ABSTRACT

BACKGROUND: Ensuring adherence to clinical practice guidelines (CPGs) is critical for improving patient outcomes. However, how the impact of guideline adherence on clinical outcomes is studied remains unclear. Our objectives are (1) to identify studies that assess the impact of adherence to CPGs; (2) to describe the research questions of these studies; and (3) to describe their study designs, methods, and reporting. We focused on CPGs addressing the pharmacologic management of major chronic diseases, specifically musculoskeletal diseases (rheumatoid arthritis, osteoarthritis, axial spondyloarthritis, and psoriatic arthritis), diabetes, and hypertension.

METHODS: We conducted a scoping review. We searched PubMed on March 3, 2023, for studies published since 2013. We included studies assessing the impact of adherence to CPGs for the pharmacologic management of adult patients. One reviewer screened the titles and abstracts and full texts and a second reviewer independently screened 20%. Two reviewers independently extracted data using a standardized pilot-tested data extraction form. Data were analyzed descriptively.

RESULTS: Of 7952 records retrieved, 16 studies were eligible for inclusion. The studies addressed CPGs for the management of diabetes (n = 8), hypertension (n = 6), and axial spondyloarthritis (n = 2). All studies were cohort studies, but none emulated a target trial. The median number of participants analyzed was 511 (IQR 350; 10,536) and the median follow-up time was 9 months (IQR 4; 18). Four studies explicitly reported the recommendations for which the impact of adherence was assessed, nine precisely defined adherence, and eight studies evaluated only surrogate outcomes. Thirteen studies accounted for confounding factors. There was serious or critical risk of bias in selection of participants in 13 studies.

CONCLUSIONS: The impact of adherence to clinical practice guidelines is rarely and inadequately evaluated. Future research should employ rigorous study designs and reporting standards to generate more reliable insights into the impact of CPG adherence.

PMID:40754575 | DOI:10.1186/s12916-025-04257-x

Neurosurg Rev. 2025 Aug 4;48(1):587. doi: 10.1007/s10143-025-03713-9.

ABSTRACT

BACKGROUND AND OBJECTIVES: Elderly patients with subarachnoid hemorrhage (SAH) face a disproportionately high burden of morbidity and mortality. While endovascular coiling is often favored in this population, direct comparisons with surgical clipping are limited. We conducted a meta-analysis to compare outcomes of clipping versus coiling in SAH patients aged ≥ 60 years.

METHODS: A systematic search of PubMed, Embase, and Cochrane databases identified studies comparing the two treatments in this age group. The primary outcome was a composite of unfavorable outcomes (modified Rankin Scale [mRS] > 2 and mortality). Secondary outcomes included mortality, favorable outcome (mRS 0-2), rebleeding, and hospital length of stay. Heterogeneity was assessed using I² statistics, with subgroup analysis by age decade.

RESULTS: Twenty-seven studies (2 randomized controlled trials [RCTs]) involving 51,415 patients (59.6% treated with clipping) were included. There were no significant differences between clipping and coiling for unfavorable outcome (RR 1.03; 95% CI 0.96-1.11), favorable outcome (RR 1.02; 95% CI 0.93-1.11), mortality (RR 1.08; 95% CI 0.97-1.19), or rebleeding (RR 1.21; 95% CI 0.57-2.57). However, coiling was associated with shorter hospital stays (MD -2.53 days; 95% CI -4.58 to -0.49; p = 0.0152). RCTs showed a non-significant trend favoring coiling, while observational studies leaned toward clipping. Heterogeneity for main outcomes was moderate (I² = 57.7%). Using the GRADE framework, overall certainty of evidence was rated very low, mainly due to the predominance of non-randomized studies, moderate risk of bias, and inconsistency across studies.

CONCLUSIONS: In SAH patients aged ≥ 60 years, clipping and coiling show comparable outcomes, with coiling associated with shorter hospital stays. Given the very low certainty of evidence, these findings should be interpreted with caution. Prospective multicenter cohorts are needed to establish more definitive evidence.

PMID:40754563 | DOI:10.1007/s10143-025-03713-9