Nevin Manimala

Crit Care. 2025 Jun 6;29(1):232. doi: 10.1186/s13054-025-05420-9.

ABSTRACT

BACKGROUND: Despite widespread vaccination efforts, effective treatment strategies remain critical for severe SARS-CoV-2 infection. Tumour necrosis factor-alpha (TNF-α) plays a central role in the cytokine storm characteristic of severe COVID-19. This systematic review and meta-analysis evaluates the effectiveness, efficacy, and safety of TNF-α inhibitors in the management of COVID-19.

PATIENTS AND METHODS: A systematic review of PubMed, Embase, and CENTRAL was conducted, focusing on studies involving SARS-CoV-2-infected patients treated with TNF-α inhibitors compared with those receiving standard of care without prior TNF-α inhibitor use. Data from studies published up to August 12, 2024, were analysed. Outcomes assessed included mortality, invasive mechanical ventilation, and C-reactive protein (CRP) levels. Odds ratios (ORs) and mean differences (MD) were calculated with 95% confidence intervals (CI), and subgroup analyses were performed for randomised controlled trials (RCTs) and non-randomised studies.

RESULTS: Seven studies involving 1393 patients with moderate-to-critical COVID-19 were included. TNF-α inhibitor treatment was associated with a reduced odds of mortality (OR 0.67, 95% CI [0.44-1.00], P = 0.052), which was statistically significant in the RCT subgroup across three studies (OR 0.75, 95% CI [0.58-0.97], P = 0.042, certainty of evidence: very low). The number needed to treat for mortality was calculated to be 16 (95% CI 9.0-inf.), which indicates that one additional death could be avoided for every 16 patients treated with TNF-α inhibitors compared to standard of care. No significant reduction in the need for invasive mechanical ventilation was observed (OR 0.95 [95% CI 0.46-1.94]; P = 0.822). Additionally, TNF-α inhibitors resulted in a significant reduction in CRP levels (MD – 21.9 mg/L [95% CI – 38.46 to – 5.34]; P = 0.024) within three to seven days post-treatment.

CONCLUSION: Our study indicates a potential role for TNF-α inhibition in the treatment of COVID-19 as their use was associated with reduced mortality, but further studies are needed to provide robust evidence.

PMID:40481519 | DOI:10.1186/s13054-025-05420-9

BMC Public Health. 2025 Jun 6;25(1):2124. doi: 10.1186/s12889-025-23215-z.

ABSTRACT

BACKGROUND: Respiratory infections claim lives, especially the lives of children under the age of five, around the world. In South Sudan, respiratory infection has been identified as one of the three leading causes of death among children. In addition to other sources of indoor air pollution, cooking elsewhere inside the house but not in the kitchen is a major contributor to indoor air pollution. South Sudan has no access to clean energy for cooking and relies entirely on biomass. Therefore, this study aims to examine the effect of indoor air pollution, proxied by cooking location, on the occurrence of respiratory infection among children under five in South Sudan.

METHOD: The study used the 2010 South Sudan Household Health Survey 2 data, with 6,307 observations of under-five children. To address potential endogeneity, a Two-Stage Residual Inclusion was employed within the logistic regression framework. Additionally, a control function approach was adopted to account for unobserved heterogeneity, if any, in the model.

RESULTS: Cooking elsewhere inside houses but not in the kitchens increases the probability of respiratory infection among children under the age of five in South Sudan. Control variables such as the roofing of the house, the gender of the under-five child, and the gender of the head of the household also influence the probability of respiratory infection among this age group.

CONCLUSION: Cooking elsewhere inside houses but not in the kitchens while using biomass for cooking has been dangerous for the health of children under the age of five. To save lives, especially those of children, cooking should be done either in a kitchen or outside of houses in the interim while moving towards clean energy for cooking.

PMID:40481513 | DOI:10.1186/s12889-025-23215-z

J Phys Chem A. 2025 Jun 6. doi: 10.1021/acs.jpca.5c01146. Online ahead of print.

ABSTRACT

DFTB+ is a flexible, open-source software package developed by its community, designed for fast and efficient atomistic quantum mechanical simulations. It employs various methods that approximate density functional theory (DFT), such as density functional-based tight binding (DFTB) and the extended tight binding (xTB) approach allowing simulations of large systems over extended time scales with reasonable accuracy, while being significantly faster than traditional ab initio methods. In recent years, several new extensions of the DFTB method have been developed and implemented in the DFTB+ program package in order to improve the accuracy and generality of the available simulation results. In this paper, we review those enhancements, show several use case examples and discuss the strengths and limitations of its features.

PMID:40479742 | DOI:10.1021/acs.jpca.5c01146

Nucleic Acids Res. 2025 Jun 6;53(11):gkaf469. doi: 10.1093/nar/gkaf469.

ABSTRACT

We describe a DNA-array-based method to infer intramolecular connections in a population of RNA molecules in vitro. First we add DNA oligonucleotide “patches” that perturb the RNA connections, and then we use a microarray containing a complete set of DNA oligonucleotide “probes” to record where perturbations occur. The pattern of perturbations reveals couplings between regions of the RNA sequence, from which we infer connections as well as their prevalences in the population, without reference to folding models. We validate this patch-probe method using the 1058-nucleotide RNA genome of satellite tobacco mosaic virus (STMV), which has been shown to have multiple long-range connections. Our results not only indicate long-range connections that agree with previous structures but also reveal the prevalence of competing connections. Together, these results suggest that multiple structures with different connectivity coexist in solution. Furthermore, we show that the prevalence of certain connections changes when pseudouridine, an important component of natural and synthetic RNAs, is substituted for uridine in STMV RNA, and that the connectivity of STMV minus strands is qualitatively distinct from that of plus strands. Finally, we use a simplified version of the method to validate a predicted 317-nucleotide connection within the 3569-nucleotide RNA genome of bacteriophage MS2.

PMID:40479708 | DOI:10.1093/nar/gkaf469

Phys Rev Lett. 2025 May 23;134(20):203602. doi: 10.1103/PhysRevLett.134.203602.

ABSTRACT

While the spontaneous emission from independent emitters provides spatially uncorrelated photons-a typical manifestation of quantum randomness, the interference of the coherent scattering leads to a well-defined intensity pattern-a feature described by linear optics. We here demonstrate experimentally how the interplay between the two mechanisms in large systems of quantum emitters leads to spatial variations of photon correlations. The implementation with trapped ion crystals in free space allows us to observe the anticorrelation between photon rates and variance of the photon number distributions in chains of up to 18 ions. For smaller crystals of four ions, the transition from antibunching to bunching and super-Poissonian statistics of the scattered light is reported. For higher numbers of scatterers, the photon statistics still display a strong deviation from the fully incoherent scattering case. Our results illustrate how the interference of coherent scattering, combined with spontaneous emission, provides a control mechanism for the light statistics.

PMID:40479696 | DOI:10.1103/PhysRevLett.134.203602

Phys Rev Lett. 2025 May 23;134(20):200402. doi: 10.1103/PhysRevLett.134.200402.

ABSTRACT

We introduce a single-qubit quantum measurement engine fuelled by backaction energy input. To reduce energetic costs associated with information processing, the measurement outcomes are only used with a prescribed laziness probability in the feedback step. As a result, we show that the work extracted over consecutive cycles is a second-order Markov process, analogous to a run-and-tumble process with transient anomalous diffusion. We derive exact analytical expressions for the work finite-time moments and first-passage-time statistics. Furthermore, we find the optimal laziness probability maximizing the mean power extracted per cycle.

PMID:40479676 | DOI:10.1103/PhysRevLett.134.200402

Phys Rev Lett. 2025 May 23;134(20):207102. doi: 10.1103/PhysRevLett.134.207102.

ABSTRACT

We study the directed transport of bosons along a one dimensional lattice in a dissipative setting, where the hopping is only facilitated by coupling to a Markovian reservoir. By combining numerical simulations with a field-theoretic analysis, we investigate the current fluctuations for this process and determine its asymptotic behavior. These findings demonstrate that dissipative bosonic transport belongs to the Kardar-Parisi-Zhang universality class and therefore, in spite of the drastic difference in the underlying particle statistics, it features the same coarse-grained behavior as the corresponding asymmetric simple exclusion process for fermions. However, crucial differences between the two processes emerge when focusing on the full counting statistics of current fluctuations. By mapping both models to the physics of fluctuating interfaces, we find that dissipative transport of bosons and fermions can be understood as surface growth and erosion processes, respectively. Within this unified description, both the similarities and discrepancies between the full counting statistics of the transport are reconciled. Beyond purely theoretical interest, these findings are relevant for experiments with cold atoms or long-lived quasiparticles in nanophotonic lattices, where such transport scenarios can be realized.

PMID:40479655 | DOI:10.1103/PhysRevLett.134.207102

JCO Glob Oncol. 2025 Jun;11:e2500050. doi: 10.1200/GO-25-00050. Epub 2025 Jun 6.

ABSTRACT

PURPOSE: Thermal ablation (TA) is now a widely used treatment for cervical precancer in low- and middle-income countries. Over the past decade, TA devices have been redesigned to be more portable, user-friendly, and affordable. This analysis combines data from three large randomized clinical trials comparing the efficacy, safety, and acceptability of TA with those of the previous standard, gas-based cryotherapy.

METHODS: This analysis used Human Papillomavirus (HPV) test results at 1-year post-treatment as the primary outcome. Secondary outcomes included side effects and patient satisfaction.

RESULTS: Of the 2,948 participants treated with either TA or gas-based cryotherapy, 80.9% and 81.8% completed HPV testing at 1 year, respectively. Overall, 60.7% tested negative for HPV at follow-up, with slightly higher rates in the TA group (62.5%) compared with cryotherapy (58.7%), although the difference was not statistically significant (P value = .14). Side effects were minimal for both treatments. Severe pain was slightly more common with TA (7.6% v 3.9% for cryotherapy), but vasovagal responses were less frequent (2.3% v 7.6%). Satisfaction with treatment was high (approximately 98%) across both groups.

CONCLUSION: Our findings support the efficacy of TA in treating cervical precancer, offering an effective and practical alternative in low-resource settings. However, future research is urgently needed to address critical questions, including the standardization of treatment protocols and tailored approaches for women living with HIV.

PMID:40479636 | DOI:10.1200/GO-25-00050

JCO Glob Oncol. 2025 Jun;11:e2400554. doi: 10.1200/GO-24-00554. Epub 2025 Jun 6.

ABSTRACT

PURPOSE: Women represent a growing force in oncology but remain underrepresented in high-level positions. Gender-related challenges affect academic progression, research, and clinical practice. This manuscript aims to describes gender-based professional development challenges faced by women in oncology in Latin America (LATAM).

MATERIALS AND METHODS: We conducted a multicenter, cross-sectional study among LATAM oncologists using a 27-item questionnaire on the basis of the European Society for Medical Oncology Women for Oncology Survey. Our analysis focused on male-female disparities, excluding other gender identities. Logistic regression models were used to calculated odds ratios (ORs) for gender inequity, wage disparity, workplace and sexual harassment, and family development. Statistical analyses were performed using SPSS version 26, with the significance set at P < .05.

RESULTS: We analyzed 254 participants from Argentina, Chile, Mexico, and Peru, mostly females (88%) and based in Mexico (55%). Most were attending physicians (68%), 51.5% worked 41-60 hours, and 33.4% reported gender equity initiatives. Gender inequity was significantly higher among women (83%) than among men (37%), with the female gender identified as a risk factor (OR, 15.67; P < .001). Workplace harassment was reported by 60% of women and 19% of men, whereas sexual harassment was experienced by 34% of women and 16% of men (OR, 2.78; P < .05). Sixty-five percent reported that men had the highest salaries. Logistic regression indicated that working 20-40 hours per week was associated with the likelihood of women having children (OR, 3.0; P < .01), as was working 41-60 hours (OR, 1.97; P < .01). However, holding an attending or resident position was associated with significantly lower childbearing rates.

CONCLUSION: Our findings indicate that Women oncologists in LATAM report experiencing higher rates of gender-based inequity and harassment and remain underrepresented in leadership and high-earning roles.

PMID:40479635 | DOI:10.1200/GO-24-00554

JCO Glob Oncol. 2025 Jun;11:e2500048. doi: 10.1200/GO-25-00048. Epub 2025 Jun 6.

ABSTRACT

PURPOSE: This study aimed to explore the usage patterns, barriers, and facilitators of cancer treatment guidelines among oncologists in Latin America and the Caribbean.

METHODS: A cross-sectional survey was conducted in March 2023 among physicians in Latin America and the Caribbean who care for patients with cancer. Respondents were recruited via the ASCO member database. Data were collected using a self-reported questionnaire that assessed demographics, guideline usage, and barriers to implementation. Descriptive statistics were used to analyze the data.

RESULTS: Of the 1,265 invited physicians, 140 responded (11% response rate). Most respondents reported frequent use of guidelines, with 47.9% using them often and 40.7% always. The guidelines that were used the most were from the National Comprehensive Cancer Network (88.5%), European Society for Medical Oncology (76.3%), and ASCO (70.5%). The top barriers to guideline use included lack of diagnostic tools and access to medications (47.7%), and institutional restrictions (19.7%). Facilitators included access to necessary resources (79.8%) and country-specific guidelines (61.2%).

CONCLUSION: Although oncologists in Latin America and the Caribbean frequently rely on international guidelines, significant barriers, particularly resource limitations, impede full implementation. Addressing these barriers through improved infrastructure and adapted guidelines is essential for enhancing cancer care in the region.

PMID:40479634 | DOI:10.1200/GO-25-00048