Nevin Manimala

Int Health. 2025 Mar 25:ihaf026. doi: 10.1093/inthealth/ihaf026. Online ahead of print.

ABSTRACT

BACKGROUND: Multidrug-resistant organisms (MDROs) are important in clinical practice worldwide. As whole genome sequencing (WGS) technologies are adopted, it is key to understand the nature of MDROs before the introduction of WGS in resource-poor settings.

METHODS: A hospital-based surveillance study was conducted in the largest referral health facility in northern Nigeria. A rectal swab sample was collected from each patient and samples were investigated for extended spectrum beta-lactamases and carbapenemase-resistant Enterobacterales (i.e. ESBL-PE and CRE, respectively). These MDROs were subjected to antimicrobial susceptibility testing and multiplex PCR. Statistical analyses were used to identify any associations between MDROs and selected antibiotics.

RESULTS: The prevalence of MDROs among participants (N=168) was 87.5% (n=147) for ESBL-PE and 4.2% (n=7) for CRE. All isolates were resistant to tetracycline and co-trimoxazole; however, most MDROs were susceptible to meropenem, ceftazidime-avibactam and fosfomycin (≥70%). blaSHV (33.3%; n=49) was the predominant ESBL gene carried by the isolates, followed by combinations of blaSHV, blaCTX and blaTEM. Although no carbapenemase genes were found, all CRE isolates had the blaOXA-48 gene, which may not be associated with phenotypic carbapenem resistance observed (χ2=0.056, p=0.81).

CONCLUSIONS: Research utilising WGS and bioinformatics will elucidate more of the molecular landscape of MDROs in resource-poor settings.

PMID:40130385 | DOI:10.1093/inthealth/ihaf026

Int J Gynaecol Obstet. 2025 Mar 25. doi: 10.1002/ijgo.70080. Online ahead of print.

ABSTRACT

INTRODUCTION: Properly prepared delivery rooms are crucial for enhancing women’s delivery experiences and reducing postpartum complications. Effective communication between healthcare providers and women is equally essential for delivering respectful maternity care. This study aimed to assess delivery room appropriateness and communication effectiveness at Al-Shifa Medical Complex.

METHODS: This cross-sectional study surveyed all women who delivered at Al-Shifa Medical Complex during a 2-week period. A self-constructed questionnaire with 18 items evaluated communication during delivery, and a mini-scale assessed delivery room appropriateness. The Kruskal-Wallis test determined associations between communication, satisfaction, and sociodemographic factors (significance level, P < 0.05).

RESULTS: A total sample of 406 women was interviewed and included in the study, with a median age of 26 years (interquartile range, 23-30 years). Of the overall sample, 189 (46.6%) had a bachelor’s degree and 187 (46.1%) had completed their secondary school. The number of deliveries ranged between 1 and 9, with a median of 3 (interquartile range, 2-4). The majority of women demonstrated an excellent communication level with the medical staff (median score, 7). A total of 319 (78.6%) women were satisfied with the way medical services were provided by the medical staff (4 or 5 out of 5). Using the mini-scale, the delivery rooms were appropriate, with 64.7% of the standardized equipment and measures implemented. There was a statistically significant association between satisfaction with medical services and educational level, and the number of previous deliveries (P = 0.002 and P = 0.018, respectively).

CONCLUSIONS: While communication levels in delivery rooms were generally good, improvements are necessary to align practices with global guidelines and ensure consistently respectful care for women during delivery.

PMID:40130375 | DOI:10.1002/ijgo.70080

Iran J Immunol. 2025 Mar 25;22(1). doi: 10.22034/iji.2025.104236.2887. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 (2019) clearly demonstrates an imbalanced immune response. Variations in the function and subtypes of dendritic cells (DCs) may have effects on immune responses in COVID-19 patients and contribute to immunopathology.

OBJECTIVE: To assess the phenotype and frequency of Plasmacytoid dendritic cells (pDCs), Conventional DCs (cDCs), and double-positive DCs in COVID-19 patients admitted to the ICU and non-ICU compared to the healthy control group.

METHODS: The study included 10 healthy individuals and 25 COVID-19 patients. In the second week of their illness, Peripheral blood mononuclear cells (PBMCs) were isolated from the patients and labeled with targeted antibodies for HLA-DR, CD123, and CD11c. The samples were then analyzed using flow cytometry. The COVID-19 patients were divided into two ICU and non-ICU groups and were closely monitored throughout the study.

RESULTS: In comparison to healthy controls, COVID-19 patients exhibited a significantly lower pDCs ratio (P=0.04). Patients were categorized into two groups: (A) the ICU group (n=11; 44%) and (B) the non-ICU group (n=14; 56%). The frequency of pDC was significantly lower in ICU patients than in non-ICU patients (P<0.01). Although not statistically significant, ICU patients had a lower frequency of cDCs and double positive DCs compared to non-ICU patients. Additionally, a significant association between the age of COVID-19 patients and cDC levels was observed (p=0.049).

CONCLUSION: SARS-CoV-2 can evade attacks from the immune response by reducing the number of DCs and suppressing their function of DCs, ultimately resulting in weakened development of both innate and adaptive immunity.

PMID:40130356 | DOI:10.22034/iji.2025.104236.2887

J Mater Chem B. 2025 Mar 25. doi: 10.1039/d4tb01941e. Online ahead of print.

ABSTRACT

Biomaterials play a crucial role in modern medicine through their use as medical implants and devices. However, they can support biofilm formation and infection, and lack integration with the surrounding human tissue at the implant site. This work reports the development of novel poly(ethyl acrylate) (PEA) based copolymers that address both issues. These PEA materials were molecularly designed polymeric surfactants (surfmers) synthesised via controlled radical polymerisations to achieve different polymeric architectures, (i.e., statistical and block copolymers). These were both deposited as structured 2D films on glass coverslips and used to manufacture monodisperse 3D micro-particles with functional surfaces (via microfluidics). ToF-SIMS was used to analyse these 2D and 3D surfaces to understand: (a) the surface arrangement of the monomer sequences exhibited by the different polymer structures and (b) how this surface monomer arrangement influenced mammalian fibroblast cell and/or Staphylococcus aureus behaviour at these film/particle surfaces. In addition, the form of the fibronectin (FN) network assembly’s importance in promoting growth factor (GF) binding was probed using atomic force microscopy (AFM) on the 2D films. This confirmed that specific surfmer molecular surface organisations were achieved during film/micro-particle fabrication, which presented exterior functionalities that either prevent biofilm attachment or promote the formation of structured FN networks for GF binding.

PMID:40130352 | DOI:10.1039/d4tb01941e

Pediatr Int. 2025 Jan-Dec;67(1):e15889. doi: 10.1111/ped.15889.

ABSTRACT

BACKGROUND: A target unplanned extubation (UE) rate of <1/100 ventilator days has been recommended. Our hospital has 21 NICU beds (12 beds in NICU 2 and 3 for extremely low birth weight [ELBW] infants). In 2020, we experienced an abrupt UE increase, leading to the initiation of the Stop UNplanned eXtubation (SUNX) project. At that time, UE rate was 1.30/100 ventilator days. The aim of the SUNX project was to keep the low UE rate.

METHODS: We collected data on UE rates from April 2019 to March 2024. The intervention was implemented through Plan-Do-Study-Act cycles. Cause analysis with the Pareto chart led to the drivers, we had to deal with: judicious use of sedations, Endotracheal tube (ETT) tape loosening, and stuff number during infant care. Additionally, we did simulation training for sudden SpO₂ decrease and UE event review. We also gathered data about ELBW infant admission and their NICU stay.

RESULTS: The UE rate in total NICU was kept lower than 1/100 ventilator days after the intervention. After our intervention, we found no special cause variation. It meant that our intervention was not statistically significant. However, our intervention gradually penetrated into the NICU daily practices; judicious use of sedation, ETT tape template, body position change by two nurses, UE event review, and so on. We continued a systematic approach to preventing UE.

CONCLUSIONS: Although abrupt UE increase in 2020 might be a special cause variation, SUNX activities brought us systematic approach for UE prevention.

PMID:40130339 | DOI:10.1111/ped.15889

Multivariate Behav Res. 2025 Mar 25:1-17. doi: 10.1080/00273171.2025.2473935. Online ahead of print.

ABSTRACT

Latent class (LC) analysis is a model-based clustering approach for categorical data, with a wide range of applications in the social sciences and beyond. When the data have a hierarchical structure, the multilevel LC model can be used to account for higher-level dependencies between the units by means of a further categorical LC variable at the group level. The research interest of LC analysis typically lies in the relationship between the LCs and external covariates, or predictors. To estimate LC models with covariates, researchers can use the one-step approach, or the generally recommended stepwise estimators, which separate the estimation of the clustering model from the subsequent estimation of the regression model. The package multilevLCA has the most comprehensive set of model specifications and estimation approaches for this family of models in the open-source domain, estimating single- and multilevel LC models, with and without covariates, using the one-step and stepwise approaches.

PMID:40130336 | DOI:10.1080/00273171.2025.2473935

Diabetes Technol Ther. 2025 Mar 25. doi: 10.1089/dia.2024.0606. Online ahead of print.

ABSTRACT

Objectives: Pancreas transplantation provides long-term near-normal glycemic control for recipients with type 1 diabetes, but it is unknown how this control compares with an automated insulin delivery (AID) system. Methods: In this prospective study, we compared parameters from 31 consecutive pancreas-kidney transplantation recipients versus from 377 people using an AID-either MiniMed^™ 780G (n = 200) or Tandem t:slim X2^™ Control-IQ^™ (n = 177). Results: Compared with the MiniMed and Tandem AID groups, transplant recipients at 1 month (mean ± standard deviation [SD]: 36 ± 12 days) after pancreas transplantation exhibited significantly lower glycated hemoglobin (38 mmol/mol [36, 40] vs. 55 [53, 56.5] and 56 [54.7, 57.2], respectively), lower mean glycemia (6.4 mmol/L [6, 6.8] vs. 8.5 [8.3, 8.7] and 8.2 [8.0, 8.4], respectively), and spent more time in range (90% [86, 93] vs. 72% [70, 74] and 75% [73, 77], respectively). Time in hypoglycemia did not differ significantly between the groups. Conclusions: Overall, compared with AID treatment, pancreas transplantation led to significantly better diabetes control parameters, with the exception of time below range. Clinical trials registration number is Eudra CT No. 2019-002240-24.

PMID:40130330 | DOI:10.1089/dia.2024.0606

Pol J Vet Sci. 2025 Mar;28(1):111-122. doi: 10.24425/pjvs.2025.154019.

ABSTRACT

This study is a continuation of innovative research on the impact of the simultaneous use of standard- and small-cell combs in bee colonies on the characteristics of worker bees and bee colonies. The nests of these colonies had two types of combs: small-cell (approximate cell width/size of 4.90 mm) and standard-cell (approximate cell width/size of 5.50 mm). The aim of the study was to compare the activities of proteases and their inhibitors present on the cuticle of workers reared in small-cell combs (SMC workers) and standard-cell combs (STC workers) in colonies kept simultaneously in standard- and small-cell combs. The width/size of comb cells in which the workers were reared had a significant effect on protein concentrations and activities of the proteolytic system, i.e. proteases and their inhibitors, on the cuticle surface. Regardless of the age of the workers (1 day, 7 days, 14 days, 21 days, and 28 days), the protein concentrations were statistically significantly higher (p≤0.01) in the STC than SMC workers. The opposite was found in the case of the activities of proteases and their inhibitors: regardless of the age of the bees, the activities were significantly higher in the SMC workers. The differences between workers reared in small-cell combs and those reared in standard-cell combs may be responsible for their predispositions to perform different tasks in the colony. In our opinion, workers reared in small-cell combs are more predisposed to work as foragers outside the nest. However, this hypothesis requires confirmation in further research.

PMID:40130298 | DOI:10.24425/pjvs.2025.154019

Intern Med J. 2025 Mar 25. doi: 10.1111/imj.70015. Online ahead of print.

ABSTRACT

BACKGROUND: While identification of key risk factors for mortality has contributed to advances in healthcare, the effect of these risk factors in predicting mortality over different time horizons remains unclear.

AIMS: We sought to determine how risk factors predicted shorter-term and longer-term mortality across the age spectrum in adults.

METHODS: We used data from 11 247 adults of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Cox multivariable regression models were used to estimate hazard ratios (HRs) of shorter-term (0-10 years) and longer-term (10-20 years) all-cause and cardiovascular disease (CVD)-related mortality associated with risk factors. Models with interaction between baseline age and each risk factor were also fitted.

RESULTS: During a 20-year follow-up, 2185 deaths occurred. Smoking, diabetes, male sex and albuminuria all independently predicted shorter- and longer-term all-cause and CVD mortality. Most associations were stronger in the shorter term compared to the longer term. A notable exception was the association between smoking and CVD mortality, which was stronger in the longer term (HR 3.55, 95% confidence interval (CI) 2.57-4.90) compared to the shorter term (HR 2.06, 95% CI 1.33-3.20). The magnitude of association between most risk factors and mortality attenuated with age.

CONCLUSIONS: Classical risk factors for total and CVD mortality remain important up to 20 years after their measurement. In unselected adult cohorts, longer-term follow-up (e.g. beyond 10 years) may not provide additional information on associations of risk factors with mortality beyond that obtained in shorter-term follow-up.

PMID:40130290 | DOI:10.1111/imj.70015

G3 (Bethesda). 2025 Mar 25:jkaf063. doi: 10.1093/g3journal/jkaf063. Online ahead of print.

ABSTRACT

Aneuploidy, a condition characterized by an abnormal number of chromosomes, can have significant consequences for fitness of an organism, often manifesting in reduced fertility and other developmental challenges. In plants, aneuploidy is particularly complex to study, especially in polyploid species such as coast redwood (Sequoia sempervirens (D. Don) Endl.), which is a hexaploid conifer (2n=6x=66). This study leverages a novel Markov Chain Monte Carlo (MCMC) method based on sequence depth to investigate the occurrence of aneuploidy across the range of coast redwood. We show that aneuploidy, defined here as a whole-chromosome gain or loss, is prevalent in second-growth redwoods, predominantly as additional chromosomes, while vegetatively propagated plants frequently experience chromosome loss. Although our study does not directly assess the fitness of aneuploids, the frequency of chromosomal instability observed in vegetatively propagated plants compared to second-growth and old-growth trees raises questions about their long-term developmental viability and potential to become established trees. These findings have significant implications for redwood conservation and restoration strategies, especially as methods such as tissue culture propagation becomes the primary mode of producing nursery stock plants used in reforestation.

PMID:40130270 | DOI:10.1093/g3journal/jkaf063