Nevin Manimala

Risk Anal. 2026 Apr;46(4):e70240. doi: 10.1111/risa.70240.

ABSTRACT

During the COVID-19 pandemic, caused by SARS-CoV-2, many mathematical models and risk assessments have been created to inform policymakers on effective strategies for controlling the spread of the pathogen. These models were often developed rapidly for timely input to strategic decisions. It is prudent to evaluate the models created and learn from experience so that we can be adequately prepared for a future pandemic. One area of modeling developed during the COVID-19 pandemic was for international travel and how to safely reopen borders and to which countries. We developed an importation risk model for estimating the risk of SARS-CoV-2 infectious travelers entering any airport and parameterized it for UK airports. We ran the model using prevalence estimates from August 2020 and found that 895 (CI: 834-958) infectious travelers would arrive in a single week from the 25 countries considered. We simulated health measures on arrival to assess the efficacy of self-isolation, the policy at the time, in comparison to proposed alternatives. We found that the 14-day self-isolation is 78.0% effective (CI: 74.4-81.6), whereas a test at the airport plus an additional test 4 days later is 68.9% (CI: 64.9-73.0) effective, after accounting for 20% noncompliance. Rapidly implementing control measures for travelers from riskier countries is vital to protect public health. This methodology can be quickly updated to assess the impact of any further changes to international travel policy or disease occurrence. We assess whether our model results would be applicable for a future Disease X, the adaptability of our model, future work to ensure that the model is comprehensive, and the lessons learned from modeling during COVID-19. In particular, we highlight the importance of building flexible, transparent, and adaptable models due to the speed at which policy or the epidemiological situation can change and for use in any future pandemic.

PMID:41943181 | DOI:10.1111/risa.70240

Brain Behav. 2026 Apr;16(4):e71213. doi: 10.1002/brb3.71213.

ABSTRACT

PURPOSE: Recent studies have reported that palmitoylation plays a pivotal role in the process of angiogenesis, as well as in the motility and migration of endothelial cells (ECs). However, the role of palmitoylation in the pathogenesis of intracranial aneurysms (IAs) has not yet been systematically investigated. Moreover, alterations in DNA methylation and the expression of IA-related genes have not received sufficient attention.

METHOD: The present study aims to employ Mendelian randomization (MR) methods to investigate the causal relationships and underlying mechanisms between palmitoylation-related genes, DNA methylation, and IAs. By employing two-sample MR analysis, summary-data-based Mendelian randomization (SMR) analysis, and mediation analysis, this study drew its conclusions. Furthermore, the robustness of these conclusions was evaluated through sensitivity analyses and transcriptomics approaches.

FINDING: Our study revealed a significant positive correlation between the overexpression of the ZDHHC24 gene and increased risk of IA. For each one standard deviation increase in ZDHHC24 expression, the risk of IA increases by 21.85%. Further mediation effect analysis revealed that methylation sites cg01806972, cg10523820, cg18862171, and cg26041493 indirectly influence the occurrence of IA by regulating the expression of the ZDHHC24 gene, with mediation effects accounting for 33.19%, 26.71%, 32.93%, and 47.16% of the total effect, respectively. Sensitivity analysis provides evidence of the robustness of the research conclusion. The final transcriptomic analysis revealed a statistically significant differential expression of ZDHHC24 between experimental and control groups (p < 0.001), suggesting its potential involvement in IA pathogenesis.

CONCLUSION: ZDHHC24 overexpression is causally linked to increased IA risk, and this relationship is mediated by specific DNA methylation loci. These findings underscore the roles of palmitoylation-related gene expression and DNA methylation in IA pathogenesis, offering novel insights into the molecular mechanisms underlying IA susceptibility.

PMID:41943174 | DOI:10.1002/brb3.71213

Contracept Reprod Med. 2026 Apr 6. doi: 10.1186/s40834-026-00446-y. Online ahead of print.

NO ABSTRACT

PMID:41943171 | DOI:10.1186/s40834-026-00446-y

Antimicrob Resist Infect Control. 2026 Apr 6. doi: 10.1186/s13756-026-01742-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Implementation of infection prevention and control (IPC) practices can reduce healthcare associated infections (HAIs). There is limited insight into the implementation of IPC practices in the medical and surgical departments in Malawian hospitals. The study aimed to explore the current state of IPC policy/guidelines and their implementation gaps at two referral hospitals in Malawi.

METHODS: We conducted a cross-sectional mixed-methods situational analysis to understand the IPC landscape in the medical and surgical departments in two tertiary hospitals from September 2023 to April 2024. These methods included: (i) document review; (ii) participant observation; (iii) semi-structured interviews with healthcare workers (HCWs); (iv) key informant interviews with hospital managers; and (v) focus group discussions with cleaning staff and patient-guardians. Quantitative data from participant observations were analysed in Excel to generate descriptive statistics, while framework analysis was used for qualitative data.

RESULTS: IPC guidelines were theoretically available but inaccessible to most HCWs. Observation revealed low compliance to all five moments of hand hygiene (0-12%) and non-touch technique (9-25%), often due to a lack of IPC supplies and poor knowledge. Adherence to environmental cleaning between procedures in theatre was 50%. Training of HCWs on IPC was inconsistent, and monitoring and feedback mechanisms were largely absent. There was no clear monitoring schedule for aseptic procedures, hand hygiene, or environmental cleaning. There was limited orientation on IPC practices for patient-guardians.

CONCLUSION: We observed critical IPC gaps in both hospitals. Addressing these issues requires thoughtful implementation of multiple context-specific IPC strategies that are likely to be sustainable, such as IPC orientation for patient-guardians as they play a critical role in the Malawian healthcare system. Training of HCWs, regular monitoring and feedback on HAI/IPC practices, easily accessible IPC guidelines and improved IPC infrastructure and supplies will facilitate improved IPC practices.

PMID:41943143 | DOI:10.1186/s13756-026-01742-7

J Anim Sci Biotechnol. 2026 Apr 7;17(1):60. doi: 10.1186/s40104-026-01375-1.

ABSTRACT

BACKGROUND: Methane emissions from enteric fermentation in ruminant livestock make up 27% of anthropogenic methane emissions.

RESULTS: Screening > 1,700 lactic acid bacteria identified Lacticaseibacillus rhamnosus FNZ118 (Kowbucha™ FNZ118) and L. rhamnosus FNZ142, (Kowbucha™ FNZ142) as capable of inhibiting rumen methanogens and methane production in vitro. FNZ118 or FNZ142 fed daily to Friesian heifer calves from birth to 14 weeks substantially lowered methane production through the first year of life compared to control animals. These strains also decreased feed intake and reduced ruminal metabolite concentrations without affecting animal live weight, suggesting an improvement in feed conversion efficiency. The observed effects did not cause major changes in the structure of the rumen microbiome.

CONCLUSIONS: These findings demonstrate that early life provision of specific L. rhamnosus strains lower CH₄ production and have potential for the mitigation of enteric greenhouse gas emissions from growing dairy cattle.

PMID:41943109 | DOI:10.1186/s40104-026-01375-1

Cardiovasc Diabetol. 2026 Apr 6. doi: 10.1186/s12933-026-03171-7. Online ahead of print.

NO ABSTRACT

PMID:41943105 | DOI:10.1186/s12933-026-03171-7

Health Qual Life Outcomes. 2026 Apr 6. doi: 10.1186/s12955-026-02533-9. Online ahead of print.

ABSTRACT

BACKGROUND: Up to 30% of individuals infected with COVID-19 experience persistent symptoms, known as post-COVID-19 condition (PCC), which can impair health-related quality of life (HRQoL). While post-COVID-19 condition (PCC) is known to affect health-related quality of life (HRQoL), the specific contribution of individual symptoms remains underexplored. This study examined how specific symptoms affect HRQoL in individuals with PCC compared to those who had COVID-19 without PCC and those never infected.

METHODS: A cross-sectional survey was conducted among a nationally representative sample of 1,813 French adults through telephone and online interviews. Participants were grouped according to WHO PCC criteria, based on infection status and 31 persistent symptoms. HRQoL was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS-29), and impairment was defined as having at least two affected domains. Logistic regressions adjusted for confounders were used to assess associations.

RESULTS: Among 1,813 participants (365 with PCC, 1,270 previously infected without PCC, 178 never infected), impaired HRQoL was significantly more frequent in with PCC (36%) than in those previously infected without PCC or never infected (adjusted odds ratio: 2.02; 95% CI 1.19-3.42]). The symptoms most strongly associated with HRQoL impairment in PCC were anxiety (OR 3.75; 95% CI: 1.80-7.80), joint pain (OR 2.31; 95% CI: 1.15-4.65), and sleep disturbances (OR 2.14; 95% CI 1.08-4.25), whereas fatigue, shortness of breath, and memory issues had a weaker association with impaired HRQoL in PCC than in other groups.

CONCLUSION: PCC, and particularly joint pain, anxiety and sleep disturbance, are associated with impaired HRQoL. Targeted interventions for these symptoms may improve well-being in affected individuals.

PMID:41943096 | DOI:10.1186/s12955-026-02533-9

Int J Health Geogr. 2026 Apr 6. doi: 10.1186/s12942-026-00465-7. Online ahead of print.

ABSTRACT

BACKGROUND: Chromosomal inversions are important genetic mechanisms that facilitate local adaptation, ecological flexibility, and behavioural variation in mosquito populations. In Anopheles coluzzii, a dominant malaria vector in West Africa, the 2La inversion has been associated with desiccation tolerance, thermal resistance, and insecticide resistance. Despite Nigeria’s ecological diversity and substantial malaria burden, the spatial distribution and clinal dynamics of 2La inversion polymorphism in An. coluzzii remain poorly characterized. This study investigated the distribution of 2La inversion karyotypes across major Nigerian ecozones and examined their association with climatic gradients.

METHODS: Larvae of Anopheles mosquitoes were sampled across 12 states representing Nigeria’s southern, central, and northern ecological zones. Species identification was conducted morphologically and confirmed with PCR diagnostics. The 2La inversion was determined using established molecular assays, and allele frequencies were analyzed with respect to ecozone and climatic gradients. Spatial distribution maps and statistical analyses, including correlation and clinal trend assessment, were done in R version 4.4.

RESULTS: A clear geographic structuring of 2La inversion polymorphism was observed in An. coluzzii populations. The 2La/2La homokaryotype was strongly predominant in the northern Sahelian and Sudan savanna ecozones, reflecting adaptation to hot and arid conditions. In contrast, the standard 2La+/2La+ arrangement was predominant in humid southern forest and mangrove regions. The heterokaryotype (2La/2La+) occurred at intermediate frequencies within the central transitional belt, where ecological gradients overlap. Karyotype frequencies exhibited a pronounced latitudinal cline, with heterozygosity peaking in central Nigeria. The spatial patterns indicate that climatic pressures, particularly aridity and humidity, might be a major determinant of inversion distribution in An. coluzzii from Nigeria.

CONCLUSION: This study provides the first detailed nationwide characterization of 2La inversion polymorphism in An. coluzzii across Nigeria’s ecological zones. The strong alignment between inversion frequency and eco-climatic gradients highlights the role of chromosomal rearrangements in promoting vector survival and ecological fitness. These adaptive patterns have significant implications for malaria control, as inversion-mediated adaptability may influence resting behaviour, insecticide response, and vector persistence under climate change. Integrating chromosomal inversion surveillance into entomological monitoring frameworks will be essential for designing ecologically tailored vector control strategies in Nigeria.

PMID:41943093 | DOI:10.1186/s12942-026-00465-7

J Orthop Surg Res. 2026 Apr 6. doi: 10.1186/s13018-026-06835-y. Online ahead of print.

ABSTRACT

INTRODUCTION: The learning curve refers to the relationship between a learner’s execution of a task and the number of attempts or time necessary to perform it in a predictable, reliable, and optimal fashion. The learner’s competence in a task should improve over time as they execute the job more frequently. The present investigation aims to clarify the learning curve associated with robotic-assisted total knee arthroplasty (TKA).

METHODS: Consecutive patients undergoing total knee arthroplasty at the Department of Orthopaedic Surgery, Eifelklinik St. Brigida, Simmerath, Germany, between 2021 and 2025 were prospectively screened for participation in this clinical study. All procedures were performed through a medial parapatellar approach, following a functional alignment strategy. Implantation was performed in accordance with the manufacturer’s recommendations using the Smith & Nephew Legion Genesis II system with a posterior-stabilised polyethylene insert. Both femoral and tibial components were cemented with Palacos cement (Heraeus Medical GmbH, Wehrheim, Germany). Postoperative physiotherapy followed the standard institutional protocol. At hospital admission, demographic variables including age, body mass index (BMI), and sex were recorded. Operative time was documented for each procedure and defined as the interval from skin incision to completion of wound closure.

RESULTS: The first 200 robotic-assisted TKAs were monitored. 66% (112 of 200 patients) were women, and 47.5% (95 of 200 TKAs) were performed on the right side. The mean age of the patients was 68.6 ± 8.1 years, and their BMI was 28.6 kg/m². The exponential decay model revealed a characteristic learning curve, characterised by initial rapid gains followed by a plateau. The estimated asymptotic operative time was approximately 89.2 minutes, with a learning rate coefficient of 0.035. This implies that the majority of efficiency improvements occur early, but meaningful reductions persist beyond the 20th case. Block-wise comparisons supported the existence of an earlier functional learning threshold. Statistically significant reductions in operative time, compared with the first 10 cases, were observed from the 41st to 50th procedure block (p = 0.02), with stabilisation in the 90-minute range thereafter.

CONCLUSION: The most efficient gains occur early, and operative times stabilise at around 90 minutes after approximately 40 procedures.

REGISTRATION: German Registry of Clinical Trials (ID DRKS00030614).

PMID:41943084 | DOI:10.1186/s13018-026-06835-y

Trials. 2026 Apr 7. doi: 10.1186/s13063-026-09679-3. Online ahead of print.

ABSTRACT

BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections, contributing to increased antibiotic consumption and high healthcare costs. Clinical studies suggest that probiotics can be effective dietary supplements reducing the risk factors for the development of infections in the intestine and vagina. In this study, we investigate the effect of the orally ingested probiotic combination ASTARTE™ on the composition of bacteria in vaginal and fecal samples, as well as on the occurrence of bacteriologically confirmed UTIs in women of reproductive age.

METHODS: A randomized, placebo-controlled, double-blind study evaluating the effect of the probiotic combination ASTARTE™ (Chr. Hansen A/S, Part of Novonesis Group, Denmark) on reducing the number of recurrent urinary tract infections (rUTIs) in women aged 18-40 years. Participants are randomized (1:1) to receive one daily probiotic capsule (5 × 10⁹ CFU) containing Lactobacillus crispatus LBV 88™ (DSM22566), Lacticaseibacillus rhamnosus LBV 96™ (DSM22560), Lactobacillus jensenii LBV 116™ (DSM22567), and Lactobacillus gasseri LBV 150N™ (DSM22583), or placebo, for 6 months. Assessments, including symptom questionnaires, urine culturing and microbiome analysis of vaginal and rectal samples by shotgun sequencing, are conducted at baseline, 2, 4, and 6 months. Compliance is tracked by unused capsule counts. Follow-up visits occur at 8, 10, and 12 months. The primary outcome is the incidence of symptomatic bacteriologically confirmed UTIs during the 6 months intervention period. The secondary objective is the effect of ASTARTE™ on changes in vaginal and gut microbiome.

DISCUSSION: This randomized, placebo-controlled, double-blind study investigates the effectiveness of ASTARTE™ in restoring beneficial microbiomes and reducing UTI recurrence. The findings will provide valuable evidence on the effectiveness of a non-antibiotic strategy for the prevention of rUTI as well as insights into the complex interactions between the vaginal and gut microbiome and the risk of rUTI.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05553652. Registered 21 September 2022.

PMID:41943076 | DOI:10.1186/s13063-026-09679-3