Category: Nevin Manimala

Eur Radiol. 2025 Oct 2. doi: 10.1007/s00330-025-12033-x. Online ahead of print.

ABSTRACT

Diffusion-weighted imaging (DWI) offers critical insights into tissue microstructure through the assessment of water molecule random displacements and plays a central role in the assessment of neoplastic and non-neoplastic diseases. To successfully implement and use DWI in clinical practice, guidelines for acquisition, interpretation of image contrast and of artefacts should be followed, taking the disease process and body part into account. We recommend covering a b-value range of 0-1000 s/mm² in the brain (along at least six directions for white matter), and 50-800 s/mm² in the body. Available acquisition acceleration options should be used to reduce repetition time (TR), echo time (TE), and echo-planar imaging (EPI) distortions, while considering the penalty in signal-to-noise ratio (SNR) and image sharpness. DW images and the apparent diffusion coefficient (ADC) map should be read jointly for the clinical interpretation. Areas of slower diffusion are hyperintense on DW images and hypointense on the ADC map, and vice versa. Magnetic susceptibility distortions and signal drop-outs or pile-ups are particularly pronounced at air-tissue or metal-tissue interfaces and may obscure areas of interest or hinder the co-localisation with structural scans. By following these guidelines and recommendations, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications. KEY POINTS: This article provides an overview of DWI principles, clinical applications, potential pitfalls, and emerging advances, alongside expert recommendations for optimal implementation. We provide key considerations tailored to specific applications (neuro and whole-body imaging), including protocol optimisation, adherence to established guidelines, and quality assurance measures to minimise artefacts and ensure reproducibility. By following the guidelines and recommendations summarised in this work, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications.

PMID:41037070 | DOI:10.1007/s00330-025-12033-x

J Anim Breed Genet. 2025 Oct 2. doi: 10.1111/jbg.70018. Online ahead of print.

ABSTRACT

In order to investigate the applicability and efficiency of genomic selection for growth and carcass traits in Nordic beef cattle, single-step genomic BLUP (ssGBLUP) was applied in 4321 Charolais and 4532 Hereford animals with information on approximately 43,000 SNPs each. Statistics including dispersion value (b1), accuracy ratio and the relative accuracy improvement were estimated for genotyped female animals in the validation set. For estimating dispersion, accuracy ratio and relative accuracy improvement, the Legarra-Reverter linear regression (LR) method was used by truncating the phenotypes after 2018, and the validation set comprised females born from 2019 to 2021. Moreover, for ssGBLUP, different alpha values of 0.95 and 0.70 were utilised as weights on the genomic information when the H matrix was blended for the genomic relationship matrix G and the pedigree relationship matrix A. In general, implementing ssGBLUP led to higher accuracy ratios and improved dispersion values (b1 value closer to the optimum value of one), compared to when using pedigree-based BLUP (PBLUP). Using an alpha value of 0.70 gave a dispersion value closer to one compared with when using an alpha value of 0.95. Additionally, the relative accuracy estimation was improved substantially for several traits by using ssGBLUP instead of PBLUP, with the highest (30%) relative improvement for carcass conformation in Swedish Hereford cattle. In conclusion, ssGBLUP would be beneficial to implement in the future Nordic beef cattle breeding programs.

PMID:41036609 | DOI:10.1111/jbg.70018

Cancer Med. 2025 Oct;14(19):e71232. doi: 10.1002/cam4.71232.

ABSTRACT

BACKGROUND: The triglyceride glucose (TyG) index, a simple and reliable surrogate marker of insulin resistance (IR), has garnered increasing attention in metabolic research. Although IR is mechanistically linked to carcinogenesis through multiple pathways, including chronic inflammation, hyperinsulinemia-driven pro-mitogenic signaling, and altered adipokine secretion, the specific utility of the TyG index for cancer risk assessment remains unclear. This systematic review examines whether the TyG index shows consistent associations across cancer types and holds value as an independent risk predictor beyond established metabolic syndrome components.

METHODS: We systematically searched PubMed, Embase, and Web of Science databases from 2008 (the year the TyG index was established as an IR marker) to December 31, 2024, for studies on the TyG index-cancer association. Cohort, cross-sectional, and case-control studies were included. Using meta-analysis, we pooled effect sizes and conducted subgroup analyses by gender, region, population source, and study design. Trial sequential analysis (TSA) evaluated evidence reliability.

RESULTS: This meta-analysis incorporated a total of 20 eligible studies. Our findings demonstrated that elevated TyG index levels were significantly associated with increased risks of various malignancies, including digestive system cancers (OR: 1.22, 95% CI 1.13-1.31), urogenital system cancers (OR: 2.04, 95% CI 1.53-2.71), and breast cancer (OR: 1.64, 95% CI 1.49-1.80) when compared to lower TyG index levels. These associations remained consistent across all pre-specified subgroup analyses stratified by study characteristics. Furthermore, TSA confirmed sufficient statistical power for definitive conclusions.

CONCLUSIONS: The consistent observed association between elevated TyG index and increased cancer risk highlights its potential as a candidate biomarker for further investigation. While these findings support the biological plausibility of insulin resistance in oncogenesis, current evidence-partially derived from observational studies-cannot establish causality or direct clinical utility. Future research should prioritize: (1) prospective validation of TyG index thresholds for cancer risk prediction, (2) mechanistic studies elucidating its role in tumor biology, and (3) assessment of its incremental value to existing risk stratification tools.

PMID:41036596 | DOI:10.1002/cam4.71232

Physiol Rep. 2025 Oct;13(19):e70592. doi: 10.14814/phy2.70592.

ABSTRACT

This study investigated the effects of high-intensity functional training (HIFT) on hormonal and inflammatory biomarker responses during military service. One hundred and twenty-seven male conscripts were assessed over a 19-week training period. The experimental group (EXP: n = 64) followed a structured HIFT program, while the control group (CON: n = 63) adhered to conventional military physical training. Blood samples were collected at baseline (PRE), week 10 (MID), and post-intervention (POST) to measure serum testosterone, cortisol, testosterone/cortisol ratio, insulin-like growth factor 1 (IGF-1), sex hormone-binding globulin (SHBG), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α). Body composition and physical performance were also measured. Serum testosterone increased in both groups between PRE and POST (EXP: +3.3 ± 3.8 nmol·L^-1, p < 0.001; CON: +3.7 ± 3.4 nmol·L^-1, p < 0.001), while cortisol remained unchanged. Testosterone/cortisol ratio increased in both groups (+0.010 ± 0.010, p < 0.001 for both). IGF-1 increased in CON (+4.4 ± 5.9 nmol·L^-1, p < 0.001) and SHBG increased in EXP (+3.1 ± 9.0 nmol·L^-1, p = 0.005). Inflammatory biomarkers (hs-CRP, IL-6) decreased in both groups. No adverse biomarker responses were observed, suggesting that HIFT was well tolerated during military service.

PMID:41036582 | DOI:10.14814/phy2.70592

Acta Orthop. 2025 Sep 30;96:726-734. doi: 10.2340/17453674.2025.44752.

ABSTRACT

BACKGROUND AND PURPOSE: Pediatric proximal femoral fractures are rare and frequently complicated fractures with avascular necrosis (AVN), nonunion, deformity, leg-length discrepancy (LLD), and premature physeal closure (PPC). Our aim was to describe the incidence, complications and functional outcomes.

METHODS: In this register-based study from a 10-year period (2014-2023) we identified 51 non-pathological proximal femoral fractures from the KIDS Fracture Tool database. Statistical yearbooks of Helsinki were utilized to estimate annual incidence. We used interviews and Oxford Hip Scores (OHS) for functional outcome assessment. If any symptom or functional deficit was described, or if Oxford Hip Score (OHS) was < 41, patients were also invited for clinical examination and radiography.

RESULTS: 51 patients with a proximal femoral fracture (31 boys) were identified representing 0.2% (51/21,121) of all child fractures with a population-based annual incidence of 1.7/100,000 children. We interviewed 46/51 of the patients or their guardians via telephone. 6/46 were invited for clinical examination and radiography. Median follow-up of contacted patients was 4 (range 1-9.5) years. Complications occurred in 9/20 patients with collum and trochanteric fractures (pain from osteosynthesis 4, AVN 3, nonunion 1, coxa vara 1, LLD 1, PPC 0) and in 7/31 with subtrochanteric fractures (pain from osteosynthesis 5, misplaced pins 2, angular deformity 1, peri-implant fracture 1). All underwent reoperation. The median OHS was 48 (interquartile range 47-48) at last follow-up. Functional outcomes were impaired in 3 patients. All 3 had AVN.

CONCLUSION: The incidence of non-pathological pediatric proximal femoral fractures is low. Despite frequent complications, impaired functional outcomes concerned only patients with AVN at median 4-year follow-up.

PMID:41036566 | DOI:10.2340/17453674.2025.44752

Clin Cancer Res. 2025 Oct 2. doi: 10.1158/1078-0432.CCR-25-0098. Online ahead of print.

ABSTRACT

The maximum tolerated dose has historically been the recommended phase two dose, and this dosage has typically been evaluated in registrational clinical trials for oncology drugs. With the emergence of targeted therapies, this approach may lead to the investigation of unnecessarily high dosages that elicit additional toxicity without added benefit. The utilization of innovative trial designs and model-informed approaches during clinical development can potentially lead to more informed dosage selection. Exposure-response analyses, clinical utility index, and other model-informed approaches have been successfully applied to understand preliminary activity and safety data for various classes of modern oncology drugs, providing insight to support the proposed dosage(s) for the registrational trial. Seamless trial designs have also played an important role in dosage selection by leveraging pre-planned flexibilities and statistical procedures to increase efficiency during the conduct of trials. Critically, both approaches can be fit for purpose, allowing for adaptation and the usage of the totality of relevant clinical and nonclinical data. Despite this, the evaluation of maximum tolerated dose remains prevalent in registrational trials. This article, the third in a series of three describing best-practice approaches to dosage optimization in oncology drug development, highlights successful applications of and relevant considerations for innovative trial designs and model-based approaches to aid the selection of better optimized dosages for evaluation in registrational clinical trials.

PMID:41036557 | DOI:10.1158/1078-0432.CCR-25-0098

Acta Oncol. 2025 Oct 1;64:1334-1341. doi: 10.2340/1651-226X.2025.43990.

ABSTRACT

BACKGROUND AND PURPOSE: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype where the prognostic implications of primary systemic therapy followed by surgery, compared to up-front surgery and subsequent adjuvant chemotherapy (ACT), are yet to be outlined. This retrospective registry-based study aimed to compare survival outcomes between patients treated with neoadjuvant chemotherapy (NACT) versus ACT for operable TNBC in a real-world setting. Patient/material and methods: We included all patients treated with chemotherapy for operable TNBC in Sweden between 2008 and 2019 using the Swedish national research database BCBaSe 3.0. To reduce confounding by indication, we implemented propensity score matching (PSM) and main study outcomes were defined as distant disease-free survival (DDFS), breast cancer-specific survival (BCSS) and overall survival (OS).

RESULTS: A total of 4,704 patients were included in the study, of which 1,183 received NACT. Following 1:1 PSM, 837 patients in each treatment setting were available for analyses. We found no statistically significant differences in terms of DDFS (adjusted hazard ratio [aHR] 1.18; 95% confidence interval [CI] 0.93 – 1.50), BCSS (aHR 1.10; 95% CI 0.83 – 1.45) or OS (aHR 1.07; 95% CI 0.82 – 1.39) between patients treated with NACT versus ACT. However, subgroup analysis of patients with clinically node-positive disease (cN+) demonstrated a significant DDFS benefit of NACT (aHR 0.65; 95% CI 0.47 – 0.90).

INTERPRETATION: Overall, we found comparable survival among patients with TNBC treated with NACT or ACT. Considering the anticipated survival improvements when response-guided post-neoadjuvant strategies are implemented in clinical practice, our findings may support the use of NACT in operable TNBC.

PMID:41036550 | DOI:10.2340/1651-226X.2025.43990

Scientifica (Cairo). 2025 Sep 23;2025:8849948. doi: 10.1155/sci5/8849948. eCollection 2025.

ABSTRACT

Inflammation helps the immune system identify and eliminate disease-causing and foreign stimuli and initiate the healing process. Nonsteroidal anti-inflammatory drugs have been often used in treating inflammation. Synthetic drugs have been associated with severe effects, necessitating the need for alternative medicinal agents. Herbal remedies have comparatively fewer side effects, are widely available, and are arguably affordable, which makes them more attractive therapeutic agents. Ficus sycomorus is utilized by Kenya’s Mbeere community to treat inflammation. However, the science-based data to support their claim were lacking. The purpose of this study was to ascertain whether methanol (MeOH) and dichloromethane (DCM) leaf and stem bark extracts of F. sycomorus have anti-inflammatory qualities in mice. Gas chromatography-mass spectrometry (GC-MS) andliquid chromatography-mass spectrometry (LC-MS) were used in phytochemical analysis of the extracts. In anti-inflammatory assays, 6-7-week-old mice were randomly grouped into six clusters with five mice each. Group one mice were administered normal saline. Groups of two to four mice were injected with carrageenan to induce inflammation and then received various treatments. Group two mice received the vehicle (normal saline), while group three mice received diclofenac (15 mg/kg body weight [bw]). The extracts were administered to the remaining groups at 50, 100, and 200 mg/kg bw. One-way analysis of variance was used to assess for statistically significant differences, followed by Tukey’s post hoc tests in case of statistical significance. The significance threshold was inferred at p < 0.05. This study revealed significant anti-edema effects of the extracts on carrageenan-induced paw inflammation in mice. The GC-MS analysis identified fatty acids, terpenoids, and terpenes, which have been associated with anti-edema effects. In conclusion, the findings showed that the extracts have anti-edema effects and phytocompounds associated with the effects. F. sycomorus extract is hence a novel candidate for developing efficacious anti-inflammatory agents.

PMID:41036536 | PMC:PMC12483736 | DOI:10.1155/sci5/8849948

J Phys Ther Sci. 2025 Oct;37(10):524-529. doi: 10.1589/jpts.37.524. Epub 2025 Oct 1.

ABSTRACT

[Purpose] To investigate differences in knee and hip muscle strength between successful and unsuccessful single leg sit to stand tests from a 20-cm-high box (SLST 20) in healthy young adults. [Participants and Methods] Sixty-six lower limbs from 33 healthy adults (20 males, 13 females; mean age 25.4 ± 3.4 years) were classified into successful and unsuccessful groups. Isokinetic strength of the knee (flexion/extension at 60°/s) and hip (flexion/extension/abduction/adduction at 30°/s) was measured. Statistical analyses included t-tests, Kruskal-Wallis tests, and analysis of covariance (ANCOVA) using sex as a covariate. Stratified analyses were also performed. [Results] The successful group had significantly greater strength in knee flexion/extension, hip flexion, and hip adduction. ANCOVA revealed that knee flexion and extension were significantly associated with SLST 20 performance, whereas hip strength was not, after adjusting for sex. Among females, hip adduction strength was significantly greater in the successful group, with no significant difference observed in males. [Conclusion] Knee strength is crucial for SLST 20 performance, and hip adduction strength may be important, particularly in females. Therefore, sex-specific assessments and training strategies should be considered in clinical practice.

PMID:41036527 | PMC:PMC12483485 | DOI:10.1589/jpts.37.524

Parkinsons Dis. 2025 Sep 23;2025:2386302. doi: 10.1155/padi/2386302. eCollection 2025.

ABSTRACT

Background: Previous studies revealed that optical coherence tomography (OCT) and visual evoked potential (VEP) were impaired in patients with Parkinson’s disease (PD), but the results were inconsistent; in this meta-analysis, we tried to answer this issue by including studies that performed these two tests on the same sample size. Methods: PubMed, Scopus, Cochrane, and Google Scholar were comprehensively reviewed to retrieve the published studies investigating changes in OCT and VEP responses in PD patients. We analyzed the pooled weighted difference in means between PD patients and healthy controls using the random-effects model. Results: Ten studies were included (12 sets of data), enrolling 337 PD patients and 273 healthy controls. The P100 latency in PD patients was significantly higher compared to healthy controls (difference in means = 6.16, 95% CI: 1.16-11.15, p=0.02, n = 11). Significant thinning of the retinal nerve fiber layer (difference in means = -4.38, 95% CI: -6.29 to -2.47, p ≤ 0.001, n = 11) was observed in the PD eyes compared to the healthy subjects. However, no statistically significant difference was found in the means of P100 amplitude (p=0.06) and the average central foveal thickness (p=0.08) between PD patients and the control group. There was a significant negative correlation between RNFL weighted mean difference and P100 latency (r = -0.65, p ≤ 0.001) in all subjects. Conclusions: Our results confirmed that Parkinson’s patients showed significant thinning of RNFL thickness and prolonged P100 latency time.

PMID:41036516 | PMC:PMC12483749 | DOI:10.1155/padi/2386302