Nevin Manimala

Sci Adv. 2025 Mar 7;11(10):eadr6413. doi: 10.1126/sciadv.adr6413. Epub 2025 Mar 5.

ABSTRACT

Credible projections of Arctic warming and wetting (AWW) are essential for informed decision-making in a changing climate. However, current AWW projections from state-of-the-art climate models carry uncertainties. Using observational datasets and CMIP6 model simulations, we demonstrate that the observed historical global warming trend and the climatological mean pattern of Arctic sea ice can serve as effective constraints on AWW projections. Under SSP2-4.5, the constrained warming by the end of the century is reduced from 5.5° to 4.6°C. Similarly, the projected wetting decreases from 6.8 to 5.7 millimeter per month. The inter-model spread in warming and wetting is reduced by 25 and 15%, respectively. The reduction is the largest in the Barents-Kara seas, reducing warming by 1.2°C, lessening wetting by 1.7 millimeter per month, and decreasing the inter-model spread by one-third. Our findings suggest that unconstrained CMIP6 projections overestimate future AWW, particularly in the Barents-Kara seas, due to an overestimation of historical global warming and excessive sea ice in the models.

PMID:40043133 | DOI:10.1126/sciadv.adr6413

PLoS Negl Trop Dis. 2025 Mar 5;19(3):e0012898. doi: 10.1371/journal.pntd.0012898. Online ahead of print.

ABSTRACT

BACKGROUND: Zika produced the highest increase in the incidence of Guillain-Barré syndrome (GBS) in Latin America in the last decade. The Neuroinfections Emerging in the Americas Study (NEAS) was established in 2016 to investigate the association of emerging infectious disorders with GBS in Colombia. The present study assessed the role of preceding infections, including arboviruses and other pathogens, as risk factors for GBS.

METHODS: A case-control study was conducted prospectively between June 2016 and December 2019 in 5 Colombian cities. We recruited newly diagnosed patients with GBS and a house control plus an age and season-matched-hospital control per case. Clinical information, blood, CSF, and urine samples were used to diagnose bacterial and viral infections. Anti-glycolipid antibodies were identified in serum. Statistical analyses were performed using conditional logistic regression.

FINDINGS: Fifty-seven patients with GBS, 66·7% male, 52 years of median age, were recruited along with 77 (55 house and 22 hospital) controls. GBS was associated with presenting diarrhea (adjusted OR 10·94; 95% CI 1·8-66·29; p=0·009) and a history of recent upper respiratory tract infection (aOR 13·91; 95% CI 2·38-81·1 p=0·003). Specific recent infections did not significantly differ between cases and controls, but the number of infections was associated with GBS (aOR=1·77 95% CI 1·04-3·01 p=0·03). C. jejuni (74%), M. pneumoniae (23%), and Chikungunya (7%) were the most frequent infections. Anti-glycolipid IgG against GM1 and their heterodimer complexes were identified to be associated with GBS.

CONCLUSIONS: After the Zika epidemic, infections causing diarrhea and upper respiratory diseases contributed to the burden of GBS in Colombia. Prevention and control of food-borne pathogens could reduce the incidence of GBS in Colombia.

PMID:40043085 | DOI:10.1371/journal.pntd.0012898

Dent Med Probl. 2025 Jan-Feb;62(1):187-192. doi: 10.17219/dmp/188273.

ABSTRACT

BACKGROUND: Intracapsular injections are a recognized therapeutic method for temporomandibular joint (TMJ) pain and limited mandibular mobility. Among many injectables, injectable platelet-rich fibrin (I-PRF) is noteworthy for its safety, promising clinical results and potential regenerative effects. The minimal invasiveness of a single injection makes it attractive as compared to arthrocentesis or a series of administrations.

OBJECTIVES: This single-arm, open-label clinical trial aimed to verify the research hypothesis that a single administration of I-PRF into TMJ relieves articular pain.

MATERIAL AND METHODS: The study sample included adults with a history of TMJ articular pain treatment. A single injection of I-PRF into the affected TMJ was performed. Each patient assessed (1) articular pain within the last 7 days, (2) the articular pain provoked by a physical examination, (3) muscular pain, (4) headache, and (5) neck pain before and 14 days after the intervention. The investigator measured (6) pain-free and (7) maximal voluntary mandibular abduction.

RESULTS: The study sample included 33 patients and 44 TMJs. No adverse events were observed at the recipient sites (TMJs). The treatment reduced the spontaneous articular pain by 0.5 ±1.5 and the provoked articular pain by 1.2 ±1.9 visual analog scale (VAS) points, with the differences being statistically significant (p < 0.05). Improvement was observed in 39-48% of Wilkes II-V patients, and 5-14% experienced deterioration up to 2 VAS points. Mandibular mobility decreased by an average of 1-2 mm, and no statistically significant effect on muscle pain, headache or neck pain was recorded.

CONCLUSIONS: A single intra-articular injection of I-PRF into TMJ brings statistically significant articular pain relief, regardless of the assessment method. In non-respondents, subsequent administrations may be considered.

PMID:40043084 | DOI:10.17219/dmp/188273

PLoS One. 2025 Mar 5;20(3):e0315292. doi: 10.1371/journal.pone.0315292. eCollection 2025.

ABSTRACT

Existing research on EFL learners’ attitudes towards English language textbooks primarily investigates metaphors at the level of mental spaces, limiting insights into embodied cognition and experience. This study extends the analysis of metaphors to a more schematic level of domains/frames. We analyzed 163 metaphors from 123 Chinese university students’ perceptions of English language textbooks under the guidance of Conceptual Metaphor Theory and the meta-functions of metaphors in language education. Findings reveal textbooks’ three primary roles in learning English as i) a guide in a journey, ii) a cornerstone of a building, and iii) an appetizer in eating. The Chi-Square Test of Independence showed a moderate association between metaphor sources and emotional valence, with nature and container metaphors associated with negative evaluations. The combination of discourse analysis and statistical analysis highlights learners’ physical and emotional engagement with English language textbooks. Pedagogical implications are discussed.

PMID:40043079 | DOI:10.1371/journal.pone.0315292

PLoS One. 2025 Mar 5;20(3):e0316735. doi: 10.1371/journal.pone.0316735. eCollection 2025.

ABSTRACT

BACKGROUND: Children with human immunodeficiency virus (HIV) infection are disproportionately susceptible to bacterial infections. There are a wide range of antibacterial agents available to manage HIV positive children with bacterial infections. However, administration of antibiotics in most children is empirical which could lead to antimicrobial resistance.

OBJECTIVES: This study aimed to determine commonly prescribed antibiotics and associated symptoms in children at Arthur Davison children’s hospital antiretroviral therapy clinic in Ndola, Zambia.

METHODS: This was a cross-sectional study that analysed the antibiotic prescribing patterns from routinely collected secondary data at Arthur Davison children’s hospital. Children diagnosed with HIV before the age of 5, actively attending antiretroviral therapy clinic identified by SmartCare software and who had taken antiretroviral therapy for at least 6 months were eligible. Data were collected from files of children who met the eligibility criteria. STATA software version 16 SE (STATA Corp., College Station, Texas, USA) was used for analysis. A p-value less than 0.05 was considered statistically significant at a confidence interval of 95%.

RESULTS: From a total of 132 children included in the study, 37.9% presented with symptoms with the most common symptoms being cough (70.0%) and diarrhoea (30.0%). A larger proportion of children (62.1%) were on arbacavir/lamivudine/dolutogravr combination of antiretroviral therapy while 8.2% were on the tenoforvir alafenamide/lamivudine/dolutobravir regimen. Children who were on abacavir/lamivudine/dolutegravir regimen presented with more symptoms (48.8%) compared to those on tenofovir alafenamide/lamivudine/dolutegravir (21.0%) and tenofovir disoproxil fumarate/lamivudine/dolutegravir (18.2%) (p = 0.006). Approximately 60.0% of children presenting with symptoms were prescribed antibiotics. Co-trimoxazole was the most commonly (38.0%) prescribed, while erythromycin (2.0%) and Cephalexin (2.0%) were the least.

CONCLUSIONS: Respiratory and gastrointestinal symptoms were the most common presentations suggestive of a suspected infection requiring antibiotic prescription in HIV-positive children on ART. Despite co-trimoxazole being the prophylactic drug among HIV-positive children, it was the most common antibiotic among children presenting with symptoms suggestive of an infection. This calls for the prudent use of co-trimoxazole to avoid its resistance.

PMID:40043075 | DOI:10.1371/journal.pone.0316735

PLoS One. 2025 Mar 5;20(3):e0314808. doi: 10.1371/journal.pone.0314808. eCollection 2025.

ABSTRACT

In the summer, the high temperatures, high humidity, frequent rainstorms, and typhoons in the East China region limit the growth of SAOPOLO tomato seedlings. By using a plant factory combined with an LED artificial light environment, the light environment can be effectively controlled to produce high-quality seedlings. This study investigates the growth and energy consumption of tomato seedlings in an artificial light plant factory. The experiment compared tomato seedlings cultivated in the artificial LED light environment of a plant factory with those grown in a semi-enclosed seedling greenhouse. The study meticulously examined the actual growth and development processes of the tomato seedlings, systematically tracking and recording the specific impacts of different cultivation environments on the seedlings’ growth and development. Additionally, the experiment followed up on the fruiting conditions of the subsequent tomato plants. The experimental results show that compared to tomato seedlings grown in a greenhouse, those cultivated in the artificial light plant factory grew more slowly before grafting, characterized by slightly lower plant height, relatively smaller leaf area, and slightly thinner stems. However, after grafting, the growth rate of the tomato seedlings in the plant factory significantly accelerated, with increased plant height, leaf area, and stem diameter. On the 16th day after grafting, the cumulative leaf length and width fitting curves for the two cultivation methods coincided. Furthermore, it is noteworthy that the electricity consumption during the tomato seedling cultivation process, including that for controlling environmental temperature and humidity and the LED artificial supplemental lighting in the plant factory, was significantly lower. Over the two-month seedling cultivation period, the resource consumption in the greenhouse was 220% and 281% higher than in the plant factory, respectively. Statistical results also showed that the mortality rate of tomato seedlings cultivated in the artificial light plant factory was only 4.3%, much lower than the 6.5% mortality rate in the greenhouse. When the subsequent tomato plants were uniformly transplanted to the greenhouse for cultivation and their fruit weights were measured and recorded, the results indicated no significant difference in the fruit weights of tomatoes grown in the plant factory compared to those grown in the greenhouse. Therefore, experimental evidence confirms that cultivating tomato seedlings in an artificial light plant factory can significantly reduce cultivation costs, increase seedling survival rates, and not affect tomato quality.

PMID:40043069 | DOI:10.1371/journal.pone.0314808

PLoS One. 2025 Mar 5;20(3):e0317089. doi: 10.1371/journal.pone.0317089. eCollection 2025.

ABSTRACT

BACKGROUND: Mixed milk feeding is defined as providing formula and/or animal milk along with breast milk to infants under six months old which is prevalent in many countries. However, this practice is generally not recommended as it can reduce the intake of breast milk, depriving the infant of its optimal nutritional and immunological benefits. Unlike formula, breast milk contains complex bioactive constituents that promote intestinal and pancreatic growth and develop mucosal defenses. The aim of this study was to analyze the spatial distribution and predictors of MMF practices in Ethiopia.

METHODS: This study utilized data from the 2019 Mini-Ethiopian Demographic and Health Survey (MiniEDHS), a nationally representative cross-sectional survey conducted from March to June 2019. The total weighted sample size derived from the data examined in this study amounted to 524 infants. The data analysis used Global Moran’s I for spatial autocorrelation and the Getis-Ord Gi * statistic for local cluster analysis to assess the spatial distribution of mixed milk feeding prevalence across Ethiopia’s administrative regions and cities. Empirical Bayesian Kriging was used for spatial interpolation to estimate mixed milk feeding prevalence in unsampled areas. The analysis utilized a maximum spatial cluster size threshold of 50% of the population to detect clusters of varying sizes. Ordinary least squares regression analysis identified significant spatial predictors. In geographically weighted regression analysis, the effect of predictor variables on the spatial variation of mixed milk feeding was detected using local coefficients.

RESULTS: The overall weighted prevalence of Mixed Milk Feeding (MMF) in Ethiopia was 10.12% (95% CI: 7.8, 13.01). This prevalence shows significant regional variations across the country emphasizing regional disparities in prevalence and distribution. The Global Moran’s I statistic was 0.14, with a Z-score of 3.18 and a p-value of < 0.001, indicating a significant spatial clustering of MMF prevalence. Hotspots of mixed milk feeding were identified in Somali, Dire Dawa, and Afar, while cold spots were observed in Amhara, Tigray, Benishangul Gumuz, SNNPR, and parts of Oromia. Household wealth (middle wealth index) and lack of baby postnatal checkups emerged as key influencers of mixed milk feeding practices.

CONCLUSION: The study found significant regional variations in mixed milk feeding practices in Ethiopia. Households with middle wealth index and baby without postnatal check were significant spatial predictors of mixed milk feeding. To reduce mixed milk feeding prevalence, targeted interventions should engage community leaders, enhance breastfeeding education in maternal health services, and integrate counseling into routine healthcare to support informed maternal choices and improve child health outcomes nationwide.

PMID:40043067 | DOI:10.1371/journal.pone.0317089

J Spec Oper Med. 2025 Mar 5:7TZF-0HBX. doi: 10.55460/7TZF-0HBX. Online ahead of print.

ABSTRACT

BACKGROUND: Fresh whole blood has been the standard of care for the treatment of hypovolemia secondary to blood loss in the Tactical Combat Casualty Care guidelines since 2014. Current recommendations from the Prolonged Field Care Working Group state that the impact on mission performance is not degraded with 1 unit (450mL) of donation. Because there is limited information on combat performance after donation, the purpose of this investigation was to examine the effects of blood donation on simulated battlefield tasks in U.S. Special Forces Soldiers.

METHODS: A total of 17 U.S. Special Forces Soldiers participated in this study. Soldiers served as their own controls and were subject to blinded blood draw and a sham draw, which were ordered randomly and separated by 6 days. Outcome measures consisted of performance, capillary blood lactate, salivary osmolality, heart rate, and estimated core temperature. These measures were taken at baseline, then immediately following a 1,200-m shuttle run, 3-event stress shoot, and 5-mile run, all while wearing a typical combat load.

RESULTS: There was a moderate-to-large, statistically significant (p<0.05) increase in shuttle run time due to blood donation (δ=12.5s, Hedges’ g=1.0). We also detected moderate, statistically significant increases in shooting scores (δ=29.2s, Hedges’ g=0.5) and 8-km run times (δ=3.9m, Hedges’ g=0.7) due to blood donation. There was no interaction between event and blood draw condition for heart rate, estimated core temperature, blood lactate, or salivary osmolality. Blinding was only 26% effective, as Soldiers were able to correctly identify the procedure that they were subjected to 74% of the time.

CONCLUSION: The moderate-to-large performance decrements found in this study are somewhat greater than those of previous studies. We believe that our results may be different due to the more demanding tasks that were performed after the blood draw in our investigation.

PMID:40042893 | DOI:10.55460/7TZF-0HBX

Mil Med. 2025 Mar 4:usaf064. doi: 10.1093/milmed/usaf064. Online ahead of print.

ABSTRACT

INTRODUCTION: During the full-scale war in Ukraine, the number of military personnel suffering from combat injuries with the development of anemia significantly increased. The work aimed to generalize and study the clinical and hematological characteristics of anemia in service members who received gunshot and blast injuries during combat operations.

MATERIALS AND METHODS: We examined 264 servicemen within 6 months (main group). They took part in hostilities and received gunshot and shrapnel wounds accompanied by blood loss. The control group consisted of 87 practically healthy service members. Complete blood test was performed on an automatic hematology analyser ABX Micros ES 60 of the company Horiba ABX. We determined the level of ferritin using the enzyme immunoassay method ELISA, the concentration of serum iron using the photometric method, and C-reactive protein (CRP) using the immunoturbidimetric latex method (quantitatively). The studies’ results were processed using variational statistics. For each group of patients, the arithmetic mean (M), the standard deviation (Ϭ), and the error of the arithmetic mean (m) were calculated. We used the statistical processing package STATISTICA 10 (Statsoft Inc.).

RESULTS: Isolated injuries accounted for 50.89%, injuries to two or more anatomical areas-49.11%, injuries to limbs and large joints-30.6%, chest-14.66%, abdominal cavity-21.9%, and polytrauma-32.84%. All patients had blood loss, but its degree was not countable. The number of erythrocyte mass transfusions ranged from 2 to 7 (3.5 ± 0.7 on average). A total of 39.42% of victims were delivered in a severe condition, and 60.58% in a moderate condition. We divided the patients into the groups: 1st group (n = 60) where the blood was tested after in 1 month after injury, 2nd (n = 42)-2 months, 3rd (n = 37), 4th (n = 31), 5th (n = 26), and 6th (n = 24) in 3, 4, 5, and 6 months. We observed an initial increase in the number of leukocytes and platelets, and a decrease in the levels of erythrocytes, hemoglobin, MCV, and MCH, an increase in the absolute number of granulocytes and monocytes, and a decrease in the number of lymphocytes. In all, 7.9% of patients were diagnosed with severe anemia, 44.7% with moderate, and 40.4% with mild. The ferritin level exceeded the control group’s results almost three times, while the iron content in the blood serum was significantly reduced. The hemoglobin level did not normalize within six months in most service members with anemia (because of severity or complications of the injuries and multiple surgeries). The CRP was elevated for 6 months after injury. Correlation analysis confirmed a positive relationship between the level of hemoglobin, the number of leukocytes, and the level of CRP.

CONCLUSIONS: We view combat anemia as more than a hematology issue. It needs prompt, coordinated care from various fields. Interventions may include blood transfusions, surgery, and correcting iron levels. We can decrease the concentration of pro-inflammatory cytokines through anti-inflammatory therapy. Additionally, possible adrenergic modulation can promote erythropoiesis.

PMID:40042885 | DOI:10.1093/milmed/usaf064

JAMA Cardiol. 2025 Mar 5. doi: 10.1001/jamacardio.2025.0025. Online ahead of print.

ABSTRACT

IMPORTANCE: Patients with heart failure (HF) and mildly reduced ejection fraction (HFmrEF) or preserved ejection fraction (HFpEF) have a spectrum of risk, and the effect of therapies may vary by risk.

OBJECTIVES: To validate the Prognostic Models for Mortality and Morbidity in HFpEF (PREDICT-HFpEF) in the phase 3 randomized clinical trial Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure (FINEARTS-HF) and to evaluate the effect of finerenone, compared with placebo, across the spectrum of risk in these patients.

DESIGN, SETTING, AND PARTICIPANTS: The FINEARTS-HF trial was conducted across 653 sites in 37 countries. Participants were adults 40 years and older with symptomatic HF and left ventricular EF of 40% or greater randomized between September 2020 and January 2023.

INTERVENTION: Finerenone (titrated to 20 mg or 40 mg) or placebo.

MAIN OUTCOMES AND MEASURES: The 3 PREDICT-HFpEF risk scores for the composite outcome of cardiovascular death or HF hospitalization, cardiovascular death, and all-cause death, respectively, were calculated. Predicted risk was compared with observed outcomes. Model performance was assessed using the Harrell C statistic. The rates of the predicted outcomes (plus the composite of cardiovascular death and worsening HF events, which was the primary end point in the trial) were examined according to quintiles of risk score, as was the effect of finerenone according to risk quintiles.

RESULTS: A total of 6001 patients (mean [SD] age, 72 [9.6] years; 3269 male [54.5%]) were randomized in the FINEARTS-HF trial. The C statistics for cardiovascular death or HF hospitalization, cardiovascular death, and all-cause death at 2 years were 0.71 (95% CI, 0.69-0.72), 0.68 (95% CI, 0.66-0.71), and 0.69 (95% CI, 0.67-0.71), respectively. The risk of the composite outcomes was approximately 8- to 10-fold higher in those in the highest compared with the lowest risk quintile. The relative risk reduction with finerenone compared with placebo was consistent across the spectrum of risk for all outcomes examined (eg, interaction P value for primary outcome = .24).

CONCLUSIONS AND RELEVANCE: Results of the FINEARTS-HF randomized clinical trial demonstrate that the PREDICT-HFpEF models performed well in terms of calibration and discrimination. Baseline risk did not modify the benefit of finerenone.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04435626.

PMID:40042880 | DOI:10.1001/jamacardio.2025.0025