Category: Nevin Manimala

Sports Med Open. 2025 Nov 21;11(1):143. doi: 10.1186/s40798-025-00940-8.

ABSTRACT

BACKGROUND: There is no robust prognostic guides for patellar tendinopathy (PT), hence we do not understand who gets better, when and why. Therefore, we aimed to identify which combination of self-reported factors best predicts PT recovery. A previously validated, reliable online questionnaire battery yielded data from an international sample of professional and recreational jumping athletes with a one-year follow-up. Recovery was defined using Global Rating of Change, alongside full availability for training and competition. Data on > 100 plausible bio-psycho-social, demographic and sporting outcome predictors were collected; and a multivariable cox proportional-hazards model constructed.

RESULTS: 128 athletes with PT (30.9 ± 8.9 years; 77 males (60%); Victorian Institute of Sport Assessment Questionnaire-Patellar Tendon = 61.5 ± 16.2) provided 25,284 days at risk for analysis. Recovery rate was 45%, peaking at 6-month. The multivariable model partially predicted PT recovery with acceptable performance (optimism-corrected C-statistic:0.77, 95%CI:0.74-0.79) and internal validation. Recovery was associated with lower severity (Hazard Ratio (HR) = 1.03, 95%CI 1.02-1.05), a shorter time off sport (HR = 0.93, 95%CI 0.87-0.99), feeling more rested after sleep (HR = 1.93, 95%CI 1.13-3.28), not having multiple concurrent tendon problems (HR = 0.23, 95%CI 0.07-0.69), higher training duration (HR = 1.05, 95%CI 1.01-1.10) and symptoms being modifiable by movement (HR = 2.71, 95%CI 1.21-6.09).

CONCLUSIONS: To the best of our knowledge, this is the first study investigating outcome predictors for PT recovery in a large international cohort of jumping athletes. The exploratory recovery model showed that a combination of self-reported sports-specific and biomedical variables were predictive of PT recovery. These findings can be used to support clinical judgements of prognosis.

PMID:41269475 | DOI:10.1186/s40798-025-00940-8

Sports Med Open. 2025 Nov 21;11(1):134. doi: 10.1186/s40798-025-00908-8.

ABSTRACT

BACKGROUND: Underpowered study designs undermine the reliability of experimental research, with growing concerns regarding randomised controlled trials (RCTs) informing musculoskeletal injury management. We assessed the statistical power and sample size calculations of such RCTs.

METHODS: Electronic searches (MEDLINE and PEDro searched up to March 2024) identified meta-analyses of RCTs comparing conservative interventions for musculoskeletal injury, without restrictions on demographics, injury type, or outcome. Statistical power was estimated using two approaches: (1) meta-analytic-the RCT’s power to detect the summary effect of the meta-analysis it contributed to, and (2) conventional-the RCT’s power to detect Cohen’s small (d = 0.2), medium (d = 0.5), and large (d = 0.8) effect sizes. The RCTs’ manuscripts and registry entries were screened for sample size planning details.

RESULTS: The search identified 4737 articles, with 41 eligible meta-analyses of 266 RCTs. The median power was 42% (54% among RCTs within statistically significant meta-analyses). Less than 1 in 3 RCTs from statistically significant meta-analyses had ≥ 80% power to detect the corresponding summary effect. The number of RCTs with ≥ 80% power to detect small, medium, and large effects was 0%, 7.9%, and 37.6%, respectively. One in four RCTs reported sample size calculations; 80% expected larger effects than they observed. RCTs not reporting sample size calculations were smaller and reported larger effects.

CONCLUSION: Low statistical power permeates musculoskeletal injury research, limiting the clinical utility of many RCTs. The underlying causes of low power in this field are multifactorial and extend beyond sample size calculation alone. Enhancing study power requires methodological improvements, including robust planning, stronger theoretical frameworks, multi-center collaboration, data sharing, and the use of valid, reliable outcome measures.

PMID:41269466 | DOI:10.1186/s40798-025-00908-8

Sports Med Open. 2025 Nov 21;11(1):135. doi: 10.1186/s40798-025-00949-z.

ABSTRACT

BACKGROUND: There is controversy in the literature with regards to the short-term effects of wearing footwear with motion control features on running mechanics and whether commercially available footwear with motion control features has extra benefits compared with non-commercially available motion control footwear. In this systematic review with meta-analysis, we investigated the effects of wearing commercially available and non-commercially available footwear with motion control features versus standard shoes applied during one experimental session on lower limb joint angles and moments during running in adults.

METHODS: Five electronic databases (Scopus, PubMed, EMBASE, PEDro, Cochrane Central Register of Controlled Trials [CENTRAL]) were systematically searched for articles potentially eligible for inclusion from inception until September 2025. Footwear with motion control features were classified into commercially available motion control footwear without additional modifications (shoes with dual midsole material) versus non-commercially available footwear incorporating self-manufactured motion control features (shoes with heel flare or wedge). The main difference between these shoe types is how they control foot pronation. The control condition comprised standard (neutral) shoes. The outcome parameters were lower limb kinematics (e.g., peak rearfoot eversion) and kinetics (e.g., peak ankle inversion moment) during running. The modified version of the Downs and Black checklist was used to assess the methodological quality of the included studies. Within and between-group standardized mean differences (SMDs) with 95% confidence intervals (CI) were computed using a random-effects model to elucidate the effects of (i) wearing footwear with motion control features (both commercially available motion control shoes and non commercially available footwear with motion control features) compared to standard shoes (total effects) and (ii) commercially available motion control footwear without additional modifications versus non-commercially available footwear incorporating self-manufactured motion control features (subgroup analysis).

RESULTS: The systematic search revealed 11,623 hits and finally 18 studies were eligible for inclusion of which 14 were used for quantitative analyses. We observed significant total effects of wearing footwear with motion control features versus standard shoes during running on the peak rearfoot eversion angle (six studies; SMDs = – 0.87, 95% CI – 1.38 to – 0.35, p = 0.001, I² = 66%) and the peak knee internal rotation angle (four studies; small SMDs = – 0.30, 95% CI – 2.58 to – 0.0, p = 0.05, I² = 0%). The subgroup analyses revealed significantly lower peak rearfoot eversion in commercially available motion control footwear versus non-commercially available footwear incorporating self-manufactured motion control features (five studies SMDs = – 0.69, 95% CI – 1.19, – 0.18, p = 0.008, I² = 50%). The included studies were rated as moderate methodological quality.

CONCLUSIONS: This study revealed that wearing footwear with motion control features versus standard shoes has the potential to control rearfoot eversion and proximal segment motion in adults. The findings showed that wearing commercially available footwear with motion control features has extra benefits compared with non-commercially available motion control footwear. The observed findings for peak rearfoot eversion angle were statistically significant and clinically relevant. Nevertheless, more high-quality research is needed to elucidate the effects of footwear with motion control features application on running kinematics and kinetics as well as lower limb muscular activation.

PMID:41269461 | DOI:10.1186/s40798-025-00949-z

Jpn J Ophthalmol. 2025 Nov 21. doi: 10.1007/s10384-025-01306-z. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the association between best-corrected visual acuity (BCVA) and sarcopenia in older adults, while the relationship between low visual acuity and age-related muscle decline remains unclear.

STUDY DESIGN: Cross-sectional study.

METHODS: This cross-sectional study included 874 participants in the Kyotango Longevity Cohort Study from August 2017 to June 2022. We analyzed the association between best-corrected visual acuity (BCVA) and the presence of sarcopenia, grip strength, gait speed, and skeletal muscle index (SMI) in older adults. Logistic regression analyses were performed with sarcopenia as the dependent variable and visual acuity as the independent variable, adjusted for age, sex, body mass index (BMI), HbA1c, smoking, exercise, and alcohol consumption. Decimal BCVA was converted to the logarithm of the minimum angle of resolution (logMAR) for statistical analyses.

RESULTS: This cross-sectional study comprised 356 men and 518 women, with a median age of 72.0 years (range: 65-98 years). The prevalence of sarcopenia was 6.7% (24 cases) in the men and 5.2% (27 cases) in the women. Multivariate logistic regression analysis revealed a significant association between low visual acuity and sarcopenia for both sexes [odds ratio: 1.86, 95% confidence interval (CI): 1.23-2.81, p = 0.002 for men, and odds ratio: 1.45, 95% CI: 1.01-2.02, p = 0.038 for women).

CONCLUSIONS: This study demonstrates a significant relationship between lower visual acuity and sarcopenia. These findings support maintaining visual acuity to prevent age-related decline of physical functions.

PMID:41269445 | DOI:10.1007/s10384-025-01306-z

Eat Weight Disord. 2025 Nov 21;30(1):89. doi: 10.1007/s40519-025-01798-1.

ABSTRACT

PURPOSE: The Children’s Eating Behavior Questionnaire (CEBQ) is a reliable and widely used tool to assess eating behavior traits in children. However, currently no Danish version of the CEBQ exists. This study aimed to translate the CEBQ into Danish and investigate its psychometric properties and factor structure in children with overweight and obesity. Secondly, differences in eating behavior traits between children with overweight and obesity were explored.

METHODS: Children (7-14 years) were recruited from a 10-week multicomponent lifestyle camp. Parents completed the CEBQ with their child before camp, and anthropometry was measured. CEBQ is scored from 1 to 5, with higher scores indicating a higher tendency toward a specific behavior. A confirmatory factor analysis (CFA) was performed to test the original eight-factor structure. Internal reliability was assessed using McDonald’s Omega.

RESULTS: In total, 190 children (12.3 ± 1.36 years) participated. The CFA confirmed the eight-factor model, with all items loading significantly on their respective factors. Internal reliability was acceptable for the full CEBQ scale (ω = 0.85) and most subscales (ω ≥ 0.70) but only moderate for Satiety Responsiveness (ω = 0.59) and Emotional Undereating (ω = 0.65). No statistically significant difference was found between children with overweight and obesity according to the Bonferroni-adjusted alpha.

CONCLUSIONS: The Danish CEBQ is a valid tool to assess eating behavior traits in Danish children with overweight and obesity; although, generalizability may be limited due to a relatively small sample size. Future studies should further validate the Danish CEBQ by assessing test-retest reliability, construct validity, and factor structure in a generalizable sample across weight categories.

LEVEL OF EVIDENCE: Level V, Cross-sectional, Psychometric study.

PMID:41269440 | DOI:10.1007/s40519-025-01798-1

Breast Cancer Res Treat. 2025 Nov 21;215(1):12. doi: 10.1007/s10549-025-07862-9.

ABSTRACT

PURPOSE: To evaluate differences in clinical outcomes, treatments received, recurrence, and sociodemographic characteristics in patients with triple-negative breast cancer (TNBC) classified as invasive lobular carcinoma (TNBC-ILC) or invasive carcinoma of no special type (TNBC-NST).

METHODS: Using national registry data, we conducted a retrospective, population-based cohort study of 6449 women diagnosed with primary TNBC (stratified by histological subtype) in Sweden (2007-2021). Clinical and treatment data were analyzed using descriptive statistics, logistic regression, machine learning (Boruta/XGBoost), and Cox proportional hazards models adjusted for patient age, tumor size, grade, nodal status, comorbidities, and receipt of adjuvant chemotherapy (ACT).

RESULTS: TNBC-ILC accounted for 2.7% of all TNBC cases and affected older patients (median age 70 vs 62 years). Compared to TNBC-NST, TNBC-ILC had lower Ki-67, fewer high-grade tumors, higher T stage, and greater socioeconomic vulnerability. Machine learning identified age and post-operative tumor size as key predictive features of TNBC-ILC. ACT was administered to 40% of TNBC-ILC versus 59% of TNBC-NST cases (P < 0.001), with a survival benefit observed only in TNBC-NST. TNBC-ILC patients aged 50-64 years were less likely to receive ACT. Despite lower proliferative activity, TNBC-ILC was associated with worse overall (OS; adj-HR 1.39, 95% CI 1.04-1.86) and disease-specific survival (DSS; adj-HR 1.98, 95% CI 1.41-2.79), particularly in patients ≥ 50 years of age. TNBC-ILC patients ≥ 75 years had the poorest 5-year survival (DSS 55%; OS 42%).

CONCLUSIONS: TNBC-ILC is a distinct subgroup with older age, lower grade and Ki-67, undertreatment, and poorer survival, emphasizing the need for age- and subtype-specific treatment strategies.

PMID:41269430 | DOI:10.1007/s10549-025-07862-9

Mol Biomed. 2025 Nov 21;6(1):114. doi: 10.1186/s43556-025-00353-9.

ABSTRACT

For over 70 years, methotrexate (MTX) has remained a first-line chemotherapeutic agent for acute lymphoblastic leukemia (ALL), playing a pivotal role in maintenance therapy. Understanding the genetic determinants of MTX efficacy is therefore essential for improving clinical outcomes. However, studies on MTX efficacy-related polymorphisms remain limited, particularly for non-coding variants, for which most evidence is based on statistical associations. Here, through integrative bioinformatics analysis and systematic meta-analysis, we identified rs1544105, a non-coding SNP in the folylpoly-γ-glutamate synthetase (FPGS) gene, as closely associated with MTX efficacy. Compared with the GG genotype, the AA genotype increased disease progression risk (OR: 2.23; 95% CI: 1.16-4.30; p = 0.017) and elevated plasma MTX concentration-to-dose ratios at 24 h (WMD: 2.27; 95% CI: 1.04-4.40; p = 0.002) and 40 h (WMC: 0.02; 95% CI: 0.00-0.04; p = 0.033). Using prime editing, we generated homozygous mutant (GG) 293T cells, demonstrating that rs1544105 A > G increased FPGS expression (~ 1.5-fold, p < 0.05) and intracellular MTX retention (p < 0.05). Moreover, both cell-based and animal experiments confirmed that rs1544105 A > G markedly improved MTX efficacy. Mechanistically, dual-luciferase reporter and electrophoretic mobility shift assays revealed that rs1544105 A > G enhanced the binding affinity of the SNP-containing sequence for the transcription factor CREB1, thereby increasing FPGS transcriptional activity and ultimately augmenting MTX efficacy. Our multidimensional study, integrating data analysis with cellular, molecular, and animal experiments, highlights the remarkable regulatory role of a single SNP, rs1544105, in modulating MTX therapeutic response and provides a basis for individualized MTX-based maintenance therapy in ALL patients.

PMID:41269429 | DOI:10.1186/s43556-025-00353-9

Discov Oncol. 2025 Nov 21;16(1):2138. doi: 10.1007/s12672-025-02403-8.

ABSTRACT

BACKGROUND: Factor Xa (FXa) plays a role in promoting cancer growth and metastasis via protease-activated receptors. The main aim of this study was to investigate the effect of FXa inhibition, which is known to play a crucial role in cancer metabolism in hypoxia, on the behaviour of colorectal cancer cell lines HCT116 and HT29 using FXa inhibitor-rivaroxaban.

METHODS: The studies were conducted under both normoxic and hypoxic conditions. The immunofluorescence method was used to assess the expression of key elements in tumor metabolism, including HIF1 alpha, LDHA, and GLUT1, following the administration of Rivaroxaban, which does not affect cell viability.

RESULTS: Hypoxia resulted in increased expression of HIF1 alpha and LDHA. However, it was observed that the expression levels decreased in the rivaroxaban-treated group. It is noteworthy that no statistically significant difference was observed in GLUT1 expression. Moreover, the analysis of E-cadherin and N-cadherin expression levels revealed that Rivaroxaban significantly impacted migration under hypoxic comparison to the control group. These findings were further corroborated by the statistical results of the wound patency in the wound healing experiment. The results reveal that the inhibition of FXa with Rivaroxaban may represent a novel target for the treatment of tumor hypoxia.

CONCLUSIONS: The findings of this study suggest that Rivaroxaban has the potential to be both an effective anticoagulant and an anticancer agent against CRC under both hypoxic and normoxic conditions. This paper puts forward an alternative utilization method for Rivaroxaban.

PMID:41269426 | DOI:10.1007/s12672-025-02403-8

Sleep Breath. 2025 Nov 21;29(6):361. doi: 10.1007/s11325-025-03537-3.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the elasticity and stiffness of the sternocleidomastoid (SCM) muscle in patients with obstructive sleep apnea syndrome (OSAS) using ultrasound shear wave elastography (SWE), and to investigate the potential relationship between SCM muscle stiffness and the severity of OSAS.

METHODS: This study included 72 patients with OSAS diagnosed by polysomnography (PSG) and 35 age- and sex-matched healthy controls who were admitted to the chest diseases outpatient clinic. Following the diagnosis, all participants underwent ultrasound shear wave elastography (SWE) to evaluate the elasticity and stiffness of the sternocleidomastoid (SCM) muscle. SWE measurements were performed in a standardized supine position, with care taken to ensure minimal muscle contraction during imaging. The mean shear wave velocity (SWV) values were recorded for both the right and left SCM muscles. The severity of OSAS was categorized based on apnea-hypopnea index (AHI) scores into mild, moderate, and severe groups. The SWE values were then statistically compared between OSAS subgroups and healthy controls. Correlation analyses were also performed between SCM stiffness (SWV) and AHI values to assess the relationship between muscle stiffness and disease severity.

RESULTS: A total of 107 individuals were included in the study: 72 patients with OSAS and 35 healthy controls. The OSAS group showed significantly higher BMI, body fat ratio, neck circumference, and sternocleidomastoid (SCM) muscle stiffness values compared to controls (p < 0.01). Shear wave elastography revealed a significant increase in SCM stiffness with advancing OSAS severity. Spearman’s correlation analysis showed that right and left SCM stiffness values were also positively correlated with OSAS severity (r = 0.164 and r = 0.241, respectively; p < 0.001).

CONCLUSION: Ultrasound shear wave elastography revealed increased SCM muscle stiffness in OSAS patients, correlating with disease severity. These findings suggest that SCM muscle biomechanical properties may serve as a supplementary marker in evaluating and monitoring OSAS progression.

PMID:41269419 | DOI:10.1007/s11325-025-03537-3

Mol Neurobiol. 2025 Nov 21;63(1):113. doi: 10.1007/s12035-025-05485-1.

ABSTRACT

Long COVID has been associated with persistent neurological symptoms that impair cognitive function and quality of life, raising questions about the role of genetic factors in symptom severity and persistence. Apolipoprotein E (APOE) polymorphisms, known for their relevance in neurodegenerative diseases, may significantly influence neurological outcomes in long COVID patients. This study aimed to investigate the relationship between APOE polymorphisms, specifically single nucleotide polymorphisms (SNPs) rs7412 and rs429358, and neurological and cognitive symptoms in long-term COVID patients. APOE genotypes were identified through the analysis of SNPs rs7412 and rs429358. Cognitive and behavioral assessments were conducted using the Mini-Mental State Examination (MMSE), the Pfeffer Functional Activities Questionnaire, the Beck Inventory for mood assessment and the Epworth Sleepiness Scale (ESS). Statistical analyses included Mann-Whitney U test, chi-square or Fisher’s exact test, and odds ratio calculation, using R Studio and GraphPad Prism. The results indicated that the ε2ε3 genotype was associated with lower scores on the BECK, suggesting fewer depressive symptoms, while the ε3ε3 genotype was linked to an increase in depressive symptoms. Furthermore, analyses of APOE alleles showed an opposite pattern concerning daytime sleepiness: carriers of the ε2 allele exhibited greater daytime sleepiness, whereas ε3 allele carriers reported less sleepiness, as measured by the ESS. The analysis of the rs7412 SNP revealed significant impacts on both BECK and ESS scores. These findings suggest that APOE polymorphisms, particularly the ε2 and ε3 alleles, play a crucial role in modulating neurological and cognitive symptoms associated with long COVID. The results highlight the potential of genetic screening to identify patients at higher risk of persistent cognitive and emotional alterations, emphasizing the importance of personalized management strategies and the need for further research in diverse populations.

PMID:41269415 | DOI:10.1007/s12035-025-05485-1