Nevin Manimala

Philos Trans R Soc Lond B Biol Sci. 2026 Feb 19;381(1944):20250002. doi: 10.1098/rstb.2025.0002.

ABSTRACT

Sepsis is a leading cause of morbidity and mortality among newborns in low- and middle-income countries, and its treatment is further complicated by high rates of antimicrobial resistance to current antibiotics. We assessed the economic impact of a proposed maternal vaccine to protect neonates against sepsis caused by Klebsiella pneumoniae in 107 low- and middle-income countries. We estimated vaccine-avertable medical expenditures, vaccine-avertable productivity losses owing to caregiver absenteeism from work, and vaccine-avertable monetized disability-adjusted life-years using a country-specific value of statistical life-year estimate. Implementing a maternal K. pneumoniae vaccine could avert US$6.9 billion (95% CI 5.6-8.3) in monetized disability-adjusted life-years annually across 107 countries. Countries in the African region displayed the highest median vaccine-avertable medical costs and productivity losses per capita associated with resistance to first- and second-line treatments compared with other regions. Low-income countries were disproportionately impacted by the increased medical expenditures associated with antimicrobial resistance, with the median price of third-line antibiotic treatment in these countries being 23.9 days of income. Our estimates indicate that a maternal K. pneumoniae vaccine could significantly reduce the societal economic burden and catastrophic health expenditures for families affected by neonatal sepsis and antimicrobial resistance in low- and middle-income countries. This article is part of the Royal Society Science+ meeting issue ‘Vaccines and antimicrobial resistance: from science to policy’.

PMID:41710952 | DOI:10.1098/rstb.2025.0002

J Interprof Care. 2026 Feb 19:1-8. doi: 10.1080/13561820.2026.2625075. Online ahead of print.

ABSTRACT

Effective interprofessional communication among healthcare teams is integral for the function of health systems. We sought to rigorously evaluate the effectiveness of clinical improvisation training in improving interprofessional communication skills among practicing providers, and to identify factors contributing to training success. We used a quasi-experimental wait-list design (intervention group n = 62; control group n = 66) to evaluate the effects of a clinical improvisational training program on interprofessional communication skills using validated baseline surveys and follow-up surveys several months later. Both groups included physicians and advanced practice nurses from various departments in a single academic medical institution. Statistical analysis was focused on examining changes in communication skills between groups and on contributors to communication change in the intervention group. Within-person changes indicated that communication skills significantly modestly improved from baseline to follow-up for the intervention group but not for the control group. Among the intervention group, we observed a significant interaction between excitement about the training and uncertainty tolerance in predicting improvement in communication skills. Clinical improvisation is likely to be effective in improving interprofessional communication skills among practicing healthcare workers. Increasing excitement about the clinical improvisation training programs and reducing uncertainty about it could bolster the success of these programs.

PMID:41710951 | DOI:10.1080/13561820.2026.2625075

Adv Sci (Weinh). 2026 Feb 19:e19640. doi: 10.1002/advs.202519640. Online ahead of print.

ABSTRACT

In situ Transmission Electron Microscopy (TEM) provides powerful insights into the reaction mechanisms of Lithium-Sulfur (Li-S) batteries. However, distinguishing intrinsic electrochemical behaviors from artifacts induced by high-energy electron beam irradiation remains a critical challenge. Here, we systematically investigate the lithiation kinetics of sulfur nanoparticles triggered exclusively by electron beam irradiation, decoupling beam effects from electrochemical driving forces. We first conduct control experiments on pure lithium oxide (Li₂O) and pure sulfur to assess their stability under electron irradiation, and then monitor lithiation behavior in a mixed system of sulfur and lithium oxide (Li₂O), under varying irradiation times and temperatures. We report a striking “explosive” lithiation phenomenon, characterized by a massive volume expansion of up to 8300% and rapid kinetics (19312 nm² s^-1), which starkly contrasts with the ∼80% expansion observed in conventional electrochemical cycling. By conducting comparative experiments across a wide temperature range (25°C to -150°C), we identify the thermal effect of the electron beam as the dominant driving force; notably, the explosive reaction is completely suppressed at cryogenic temperatures (-150°C). Furthermore, we observe unique beam-induced artifacts, including directional cavity formation and rapid phase transitions from crystalline S to amorphous Li₂S. This work establishes a critical baseline for distinguishing beam-induced damage from genuine electrochemical reactions in in situ TEM studies and provides nanoscopic insights into the thermal runaway mechanisms of sulfur cathodes under high-energy abuse conditions, underpinning accurate characterization of Li-S battery materials and development of advanced battery systems.

PMID:41710945 | DOI:10.1002/advs.202519640

Front Cell Dev Biol. 2026 Jan 28;14:1749173. doi: 10.3389/fcell.2026.1749173. eCollection 2026.

ABSTRACT

BACKGROUND: Chronic endometritis (CE), characterized by CD138⁺ plasma cell infiltration, has been proposed to impair reproductive outcomes in assisted reproductive technology (ART). However, current evidence remains inconsistent, and diagnostic criteria vary widely. This study aimed to evaluate whether CE diagnosis and antibiotic treatment influence clinical pregnancy, live birth, and miscarriage outcomes following in vitro fertilization with fresh embryo transfer (IVF-ET) and frozen embryo transfer (FET).

METHODS: We retrospectively analyzed 3,041 embryo transfer cycles (1,507 IVF-ET; 1,534 FET) from 1,401 infertile women treated at the Reproductive Medicine Center of Liuzhou Hospital, Guangzhou Women and Children’s Medical Center (2008-2023). Chronic endometritis (CE) was primarily defined as the presence of ≥1 CD138⁺ plasma cell per 10 high-power fields (HPFs, ×400). Standard therapy was doxycycline 100 mg twice daily for 14 days. Outcomes were analyzed per transfer cycle using Poisson regression with robust standard errors and propensity score weighting.

RESULTS: Untreated CE patients had comparable live birth and clinical pregnancy rates to non-CE patients in both IVF-ET (live birth 37.7% vs. 36.7%) and FET (39.0% vs. 37.9%), and were also associated with a lower observed miscarriage risk after IVF-ET (adjusted RR 0.67, 95% CI 0.46-0.97). Among CE patients, antibiotic treatment did not improve outcomes compared with no treatment (IVF-ET live birth 36.8% vs. 37.7%; FET 41.5% vs. 38.7%; all p > 0.05). Similarly, post-treatment “cured” and “persistent” CE groups showed no significant differences in live birth or miscarriage rates in either transfer type. Exploratory analyses revealed context-dependent trends, but most interactions were nonsignificant.

CONCLUSION: In this large single-center cohort, CE defined by CD138⁺ plasma cell infiltration was not associated with reduced clinical pregnancy or live birth rates, and no statistically significant benefit of antibiotic treatment was observed. The observed reduction in miscarriage risk among CE patients suggests complex immunological dynamics. Routine CE screening in all ART candidates may be unnecessary, and targeted evaluation for high-risk subgroups warrants further investigation.

PMID:41710942 | PMC:PMC12910471 | DOI:10.3389/fcell.2026.1749173

Front Vet Sci. 2026 Feb 3;13:1774042. doi: 10.3389/fvets.2026.1774042. eCollection 2026.

ABSTRACT

INTRODUCTION: Neutering in the anoestrus period is most commonly recommended for bitches due to reduced risk of intraoperative bleeding and iatrogenic pseudopregnancy. However, there is a possible second period for neutering, commencing after oestrus until the time when prolactin concentrations increase.

METHODS: This retrospective study compared reports of intraoperative bleeding (categorised in two ways: excluding and including bleeds from the skin and subcutaneous tissue/fat) and cases of pseudopregnancy between bitches neutered during an ‘early’ period (EP bitches, neutered from the end of oestrus until day 43 after ovulation, n = 319), during a ‘conventional’ period (CP bitches, neutered 90 or more days from estimated ovulation date, n = 1,993) and bitches neutered in an ‘at greatest risk’ period (GRP bitches, neutered between 44 and 89 days from estimated ovulation date, n = 231). Data for pseudopregnancy post-neutering were gathered using two methods (1) clinical indicators from electronic health records and (2) routinely collected behavioural data for behaviours that have been associated with pseudopregnancy.

RESULTS: There was no association between neuter period and the presence of an intraoperative bleed, either when excluding or including bleeding from the skin and subcutaneous tissue/fat (3.8-4.4% EP, 5.8-8.8% CP, and 7.4-11.3% GRP bitches). Only six cases of pseudopregnancy after neutering were identified in clinical records: two EP bitches (0.6%), one CP bitch (0.05%) and three GRP bitches (1.3%); associations were not evaluated statistically due to the small number of cases. Examinations of behavioural data found no association between neuter period and trait scores for ‘General Anxiety’, ‘Body Sensitivity’ and ‘Separation-related behaviours’ from dog behaviour questionnaires. However, EP (4.1%) and CP bitches (11.7%) had reduced odds of having a behaviour incident and/or development plan related to fear or anxiety and/or aggression post-neutering compared to GRP bitches (20.8%).

CONCLUSION: The results suggest that neutering bitches during the ‘early’ period may be a suitable alternative to the ‘conventional’ period. Additionally, the results support the generally well-accepted advice to avoid neutering bitches during the period of greatest risk.

PMID:41710939 | PMC:PMC12909199 | DOI:10.3389/fvets.2026.1774042

Front Vet Sci. 2026 Feb 3;13:1778321. doi: 10.3389/fvets.2026.1778321. eCollection 2026.

ABSTRACT

This article presents an overview of the update on direct embryo transfer using hatched blastocysts. Recent research has observed differences in conception rates in sheep following surgical transfer. All sessions included in the study followed the same standard protocol, resulting in the creation of two groups, with the control group (CG) being the one in which blastocysts were transferred, and the experimental group (EG) received hatched blastocysts. Embryos were obtained from meat sheep through in vivo derived (IVD) and transferred to crossbred sheep synchronized with very obvious corpus luteum (CL) on at least one of the ovaries (84.21%). Thus, a retrospective study highlights the clear success of embryo recipients who also received hatched blastocysts (code 9.1) compared to recipients with blastocysts only (code 6.1, 7.1). The embryo recovery rate at 6.5 days, determined by laparoscopic uterine flushing, was 84.3%. In terms of the quality of the embryos obtained, over 74.5% were transferable (not statistically significant, 76.6% in Suffolk and 72.3% in Ille de France), and over 12% of the embryos hatched. The study found that the pregnancy rate in recipient ewes receiving code 9.1 embryos (expanded blastocysts) through direct IVD transfer during the breeding season was 86.9%. These findings, when compared to previous research, highlight the potential for further exploration and innovation in this area. Nonetheless, it is important to note that there is a scarcity of literature addressing the direct transfer of IVD embryos with expanded blastocysts.

PMID:41710937 | PMC:PMC12909215 | DOI:10.3389/fvets.2026.1778321

BMJ Neurol Open. 2026 Feb 12;8(1):e001481. doi: 10.1136/bmjno-2025-001481. eCollection 2026.

ABSTRACT

BACKGROUND: Oscillatory whole-body vibration (WBV) training improves strength and movement skills in healthy adults and individuals with various medical conditions. Studies examining the effects of WBV on gait disorder in people with multiple sclerosis (PwMS) of progressive disease form (progressive MS (PMS)), however, produced inconsistent results.

OBJECTIVES: To assess the feasibility and explore effects of WBV training on spastic gait in PwMS.

DESIGN AND METHODS: Single-centre randomised, single-blind, pilot study involving 30 PwMS with mild-to-moderate spastic gait disorder (Expanded Disability Status Scale (EDSS) 3.0-6.5). Patients were randomised 1:1 into arm 1 (12-week standard-of-care before WBV) and arm 2 (immediate WBV). WBV was delivered using a side-alternating Galileo Med 25 TT platform as a home-training programme, complemented by a standardised exercise protocol. The primary endpoint was the 6-minute walking distance (6MWD).

RESULTS: The distribution between arms concerning age, sex, body mass index, EDSS and baseline 6MWD was balanced. Adherence to the protocol was similar across both arms, with 70% of all patients completing all three study visits, with four dropouts per arm. Efficacy analyses included participants completing ≥50% of WBV sessions, comprising 17 participants (57%). 67% of all participants experienced AEs, which were equally distributed across both groups and not severe. Participant satisfaction with the intervention was high, with 70% indicating willingness to repeat the training. After 12 weeks of WBV training, a non-significant numerical increase in median 6MWD was observed. Patient-reported spasticity, assessed using the MSSS88 (Multiple Sclerosis Spasticity Scale), showed a non-significant numerical decrease following WBV.

CONCLUSIONS: In this exploratory pilot study, we could demonstrate feasibility of a WBV intervention study in PwMS. As only 57% of the participants were able to complete the per-protocol training specifications, larger studies that intend to explore the efficacy of the WBV intervention in PMS should consider a less ambitious and a more individualised training protocol.

TRIAL REGISTRATION NUMBER: DRKS00022962.

PMID:41710925 | PMC:PMC12911677 | DOI:10.1136/bmjno-2025-001481

Front Microbiol. 2026 Feb 3;17:1741007. doi: 10.3389/fmicb.2026.1741007. eCollection 2026.

ABSTRACT

Brucellosis in water buffalo remains endemic in southern Italy, particularly in areas of the province of Caserta characterized by high animal density. This retrospective cohort study (2016-2021) assessed the effectiveness of stamping out (whole-herd depopulation) versus selective culling in counteracting brucellosis in water buffalo herds. Data from 222 outbreaks were analyzed using Cox regression, incorporating herd size, buffalo density, eradication method, and co-infection with Mycobacterium bovis. Stamping out reduced reinfection risk by 80% (HR = 0.2; p < 0.001), especially in municipalities exceeding 200 buffaloes/km². Co-infection with M. bovis was not statistically associated with reinfection. These results indicate that control strategies should prioritize stamping out, coupled with reinforced structural and operational biosecurity measures, even in high-density settings, to achieve disease-free status. Integrated surveillance and education, in line with One Health principles, are essential for sustainable eradication and protection of the buffalo dairy sector.

PMID:41710922 | PMC:PMC12909548 | DOI:10.3389/fmicb.2026.1741007

JAC Antimicrob Resist. 2026 Feb 17;8(1):dlag016. doi: 10.1093/jacamr/dlag016. eCollection 2026 Feb.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the impact of switching population pharmacokinetic models used for model-informed precision dosing (MIPD) of vancomycin on target attainment, acute kidney injury rates, dosing, and sampling burden in 90 295 patients across nineteen hospital systems.

METHODS: We assessed sites that changed their default vancomycin MIPD model on primary endpoints, including vancomycin area under the concentration-time curve (AUC) target attainment, time to target attainment, and vancomycin-associated AKI rates using an interrupted time series model. Secondary endpoints included vancomycin dosing (day 1 and total course) and sampling frequency. Hospital systems that did not change models served as controls.

RESULTS: In BMI < 40 kg/m² patients, the Goti-to-Thomson model transition significantly improved AUC target attainment on day 1 (+2.1%, P < 0.001), day 2 (+3.1%, P < 0.001), and across the whole treatment course (+2.7%, P < 0.001). Small increases occurred in vancomycin sampling per course (+0.06 samples/course, P < 0.05) and time to target attainment (+0.26 hours, P < 0.05). AUC improvements occurred without statistically significant increases in AKI incidence (KDIGO Stage 1: +0.314%, P > 0.05/3; Stage 2: +0.347%, P > 0.05/3, Stage 3: +0.034%, P > 0.05/3). No significant differences were observed in the BMI ≥ 40 kg/m² or control cohorts.

CONCLUSIONS: This large quasi-experimental study shows that switching from one pair of well-validated and highly predictive models to another improves vancomycin target attainment while maintaining low adverse event rates.

PMID:41710913 | PMC:PMC12910383 | DOI:10.1093/jacamr/dlag016

Front Oral Health. 2026 Feb 3;7:1759348. doi: 10.3389/froh.2026.1759348. eCollection 2026.

ABSTRACT

BACKGROUND: Despite increasing interest in patient-reported outcomes in implant dentistry, there is a lack of consensus on tool selection and outcome prioritization to assess patient-reported outcomes in implant dentistry. This study validates an instrument designed to support clinicians in evaluating patient experience and knowledge for personalized implant therapy.

METHODOLOGY: Patients with dental implants that had been functioning for at least one year were included in this cross-sectional study. A five-point Likert questionnaire (Implant Treatment Experience and Knowledge Scale; ITEKS) was administered to measure patients’ perceived knowledge of peri-implant health/disease and their satisfaction with the treatment. The reliability of the questionnaire was analyzed using Cronbach’s alpha. Exploratory factor analysis was used to examine the underlying structure of the questionnaire. Correlations between the OHIP-14, a widely used instrument for assessing oral health-related quality of life, and the administered scales were analyzed to examine convergent validity. The potential influence of patient-related factors (age, gender, education, source of information, and peri-implant diagnosis) was investigated.

RESULTS: A 28-item tool was used to assess dental implant treatment related awareness, satisfaction, post-treatment attitudes, and the etiology, treatment, and risk factors of peri-implantitis. The mean functional time of dental implants was 6.69 years. Psychometric properties were evaluated using exploratory factor analysis and Cronbach’s alpha. Cronbach’s alpha values for these tools were.864 and.779, respectively. Peri-implantitis was significantly associated with decreased patient satisfaction (p < .001). No statistically significant gender differences were observed for OHIP, Implant Treatment Experience Metric (ITEM), or Implant Patients Knowledge-Awareness Scale (IPKAS) scores (p > .05). Participants with advanced education exhibited significantly higher ITEM scores than those with basic education (p = .028). Furthermore, OHIP scores were significantly higher in the peri-implantitis group compared to both the peri-implant health and peri-implant mucositis groups (p < .001). Conversely, ITEM scores were significantly lower in the peri-implantitis group compared to the health and mucositis groups (p < .001).

CONCLUSIONS: The instrument demonstrated methodological suitability for assessing patient-related outcomes in individuals undergoing implant treatment, as confirmed by reliability and validity tests. These results indicate that the ITEKS is a reliable and valid instrument for assessing patient experience in implant dentistry.

PMID:41710907 | PMC:PMC12909526 | DOI:10.3389/froh.2026.1759348