Category: Nevin Manimala

J Clin Oncol. 2025 Sep 24:JCO2500925. doi: 10.1200/JCO-25-00925. Online ahead of print.

ABSTRACT

In the POLARIX study (ClinicalTrials.gov identifier: NCT03274492), polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) showed a significant progression-free survival (PFS) benefit versus rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated intermediate- or high-risk diffuse large B-cell lymphoma (DLBCL; median follow-up: 28 months). In this 5-year update, sustained PFS benefits favoring Pola-R-CHP were observed. In the global intention-to-treat population (N = 879; median follow-up: 64.1 months), Pola-R-CHP demonstrated a significant PFS benefit over R-CHOP (hazard ratio [HR], 0.77 [95% CI, 0.62 to 0.97]), with 5-year PFS rates of 64.9% (95% CI, 59.8 to 70.0) and 59.1% (95% CI, 53.9 to 64.3), respectively. Although not statistically significant, overall survival analysis showed a HR of 0.85 (95% CI, 0.63 to 1.15) at the 5-year data cut compared with 0.94 (95% CI, 0.67 to 1.33) at the 2-year data cut. In the expanded population, 46 and 62 patients had lymphoma-related deaths in the Pola-R-CHP and R-CHOP arms, respectively. Exploratory analyses showed favorable 5-year survival rates with Pola-R-CHP in high-risk subgroups, including activated B-cell DLBCL and International Prognostic Index score 3-5. Long-term tolerability was similar between treatment arms. Findings confirm Pola-R-CHP represents a standard of care for frontline treatment of DLBCL.

PMID:40991874 | DOI:10.1200/JCO-25-00925

J Trop Pediatr. 2025 Aug 8;71(5):fmaf038. doi: 10.1093/tropej/fmaf038.

ABSTRACT

Childhood drowning is a major cause of morbidity and mortality with significant economic and social implications, especially in low- and middle-income countries. Despite this, there is a lack of good-quality epidemiological data on childhood drowning. We report the epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia between the years 2000 and 2022. Data about childhood drowning were obtained from a hospital-based registry gathered by the National Health Informatics Centre, the Ministry of Health, Malaysia. Child population data were downloaded from the Malaysian Census. Overall incidence rates (IRs), case fatality rates (CFRs), and IR and CFR by age, sex, race, and region were calculated. Binary logistic regression was used to determine the factors associated with fatality. Between the years 2000 and 2022, a total of 4247 cases of drowning were reported. IR was significantly higher among children aged 0-9, boys, Bumiputera, and the East Coast and Borneo regions. Overall CFR was 3.7%. Age, year of hospitalization, and Bumiputera were associated with CFR. The site of drowning was unspecified in 84% of cases, while for those recorded, natural water sources and swimming pools accounted for most sites. While the annual incidence of drowning has remained nearly constant throughout the years, the fatality rate has increased between 2010 and 2022. Our report provides leads for further research data requirements to understand childhood drowning epidemiology better and improve preventive measures.

PMID:40991872 | DOI:10.1093/tropej/fmaf038

Medwave. 2025 Sep 24;25(8):e3111. doi: 10.5867/medwave.2025.08.3111.

ABSTRACT

INTRODUCTION: Hip and knee osteoarthritis are common causes of disability, with high social and economic impact. Total hip and knee arthroplasties are cost-effective interventions that significantly improve quality of life. However, timely access to these surgeries in the Chilean public healthcare system remains limited. Since 2019, the Diagnosis-Related Groups (DRG) system has enabled the financing of hospital surgical procedures by adjusting payments according to case complexity. The objective of our study was to describe the hospital volume, clinical profile of patients, and financing situation of arthroplasties performed between 2019 and 2023 in public hospitals operating under the Diagnosis-Related Groups system.

METHODS: Observational, cross-sectional, and retrospective study. All procedures coded as primary total hip arthroplasty or total knee arthroplasty recorded in the Diagnosis-Related Groups database of the National Health Fund (FONASA) between January 2019 and September 2023 were analyzed. Clinical, demographic, geographic, and economic variables were extracted. Comorbidities were identified using the International Classification of Diseases, 10th revision (ICD-10).

RESULTS: A total of 29 409 primary and 1993 revision arthroplasties were performed. Surgical volume decreased in 2020 and recovered progressively. Hospital productivity varied across regions. One-third of the total hip arthroplasties were performed in patients under 65 years old. The most frequent comorbidities were hypertension (43.4%) and diabetes (16.6%). The average reimbursement for revision surgeries was similar to that of primary procedures.

CONCLUSIONS: We identified regional inequities in access to total hip and knee replacements. We also found possible underreporting of comorbidities and underfunding of revisions, which highlights the need for specific adjustments to the Diagnosis-Related Groups system. In the future, it will be necessary to improve the quality of coding, expand financial coverage for patients excluded from the Explicit Health Guarantees, and incorporate technological adjustments that adequately reflect the costs of revisions, to move toward equitable and sustainable access to these surgeries.

PMID:40991867 | DOI:10.5867/medwave.2025.08.3111

J Clin Child Adolesc Psychol. 2025 Sep 24:1-15. doi: 10.1080/15374416.2025.2562520. Online ahead of print.

ABSTRACT

OBJECTIVE: Substance use, violence, and HIV/AIDS (i.e. SAVA) are three adversities known to cluster and contribute to other poor health outcomes among marginalized communities due to structural factors including racism and poverty. Most research on SAVA has focused on negative outcomes (e.g. psychopathology) among those directly affected. To address important gaps in the literature, the current study explored how child gender moderates the associations between maternal SAVA severity and child individual, relational, community, and cultural resilience.

METHOD: Participants included 263 children (M_age = 12.11, SD = 2.77; 59% girls; 82% Black) and their maternal caregivers. SAVA severity was examined as a continuous latent variable and resilience levels were calculated via confirmatory factor analysis based on manifest variables.

RESULTS: After adjusting for covariates, linear regression analyses indicated that, among girls but not boys, lower maternal SAVA severity was associated with higher individual (β = -0.22, p = .04, d = 0.01) and community (β = -0.27, p = .02, d = 0.02) level resilience. Further, across all children, lower maternal SAVA severity was associated with higher cultural resilience (β = -0.24, p < .001, d = 0.04). The association between maternal SAVA and relational resilience was not statistically significant.

CONCLUSIONS: Maternal SAVA impacts child resilience, but this effect is not uniform, as findings illustrated differential effects of SAVA by child gender and resilience level. This work emphasizes the critical need to assess and understand unique drivers of child resilience in order to intervene effectively on co-occurring adversities.

PMID:40991863 | DOI:10.1080/15374416.2025.2562520

J Am Acad Orthop Surg. 2025 Sep 24. doi: 10.5435/JAAOS-D-25-00582. Online ahead of print.

ABSTRACT

INTRODUCTION: As limb lengthening techniques have evolved from external fixation to motorized internal lengthening nails (MILN), it is anticipated that the length of stay (LOS) required and the readmission rates reported after these procedures will improve. The primary aim of this study was to describe the length of stay and readmission rates in a contemporary lengthening cohort. The secondary aim was to explore variables associated with LOS and readmission rates.

METHODS: This was a retrospective cohort study analyzing 213 limb lengthening events at a single center between October 2016 and June 2022. Most patients were male (145/213; 68%), White (126/213; 59%), and privately insured (183/213; 86%). Linear regression, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze the effects of independent variables on LOS. Binary logistic regression or Pearson Chi-square test were used to analyze the effects of independent variables on readmission (postdischarge hospitalization of >24 hours).

RESULTS: The median LOS was 3 days (IQR 2 to 3 days). The mode LOS was 2 days occurring after 89 of 213 procedures (41.8%). Increasing age (P = 0.002), patient-reported ethnicity (P = 0.037), and surgical day of the week (P < 0.001) were associated with increased length of stay. Patient sex (P = 0.317), insurance status (P = 0.166), concurrent deformity correction (P = 0.811), and bilateral lengthening (P = 0.314) were not associated with LOS. Overall, 30 readmission events (14.1%) were reported; most commonly delayed union requiring fixation exchange in 16 of 30 readmissions (53%). The only variable statistically significantly associated with readmission was increasing age (P = 0.003).

CONCLUSION: The median length of stay was 3 days with a mode of 2 days. The readmission rate was 14.1%. Increasing age, patient ethnicity, and surgical day of the week were associated with increased LOS, whereas readmission was associated with increasing age. This characterization may help as a guide when counseling patients on the expected postoperative course for a limb lengthening procedure.

PMID:40991862 | DOI:10.5435/JAAOS-D-25-00582

J Strength Cond Res. 2025 Oct 1;39(10):e1188-e1194. doi: 10.1519/JSC.0000000000005183.

ABSTRACT

Hunzinger, KJ, Pollen, TR, Bilimoria, AM, Hough, AK, Hough, JD, Lutz, VN, Medagam, RH, and Schneider, ALC. Representation of women authors in 4 decades of rugby research. J Strength Cond Res 39(10): e1188-e1194, 2025-Gender bias in scientific publication, particularly authorship, is common; however, its extent in rugby research remains unclear. This study examined the prevalence of authorship by gender among first, last, and corresponding authors of rugby research over 4 decades. Indexed rugby studies published through September 29, 2024, were collected from 3 databases (Web of Science, Embase, and PubMed). Articles were screened by 2 reviewers, with a third reviewer for consensus. Author gender was identified through names and regional data using the Genderize database. Percentages of women authors were calculated, and Fisher’s exact tests compared first or corresponding author gender pairs. Logistic regression assessed trends over time by role, publication year, and author count. Of 10,142 articles screened, 2,258 (22.3%) were included. Women represented 20.0% of first authors, 16.0% of last authors, and 17.9% of corresponding authors. Publication frequency increased over time for both genders, but the gender ratio remained stable. The most common first/corresponding author pairing was man/man (71.6%), significantly higher than other author gender pairs (p < 0.001). Publication year was associated with increased odds of female first and corresponding authorship (both p-trend < 0.05), and more authors per paper was associated with increased odds of woman first author (OR = 1.04 [95% CI = 1.00-1.08]). Consistent with other fields, women authors are underrepresented in rugby research. These disparities may limit diverse perspectives in the field and hinder the visibility and career advancement of women researchers. Potential underlying factors driving these disparities should be investigated to inform policies that promote equitable access to funding, research opportunities, and leadership roles in rugby science.

PMID:40991854 | DOI:10.1519/JSC.0000000000005183

Genes Brain Behav. 2025 Oct;24(5):e70036. doi: 10.1111/gbb.70036.

ABSTRACT

The amygdala participates in the processing of stimulus signals from stimuli and the coordination of the physiological and behavioral responses. The sexually dimorphic structure of the amygdala also contributes to sex-specific molecular and functional profiles. The present study compares the response of the amygdala molecular mechanisms to different environmental stimuli between sexes. The amygdala of female and male pigs was profiled under control, immunostimulation, and the metabolic stimulus of fasting using RNA-sequencing. Differential expression analysis (False Discovery Rate -adjusted p value < 0.05) identified 958 genes affected by stimulus and 504 genes affected by sex within treatments. The functional categories presenting a predominance of differentially expressed genes included the synaptic vesicle cycle pathway, vascular smooth muscle contraction pathway, epithelial cell proliferation process, chemokine signaling, and apoptosis. Network analysis revealed hub genes, including Stx1a, Cplx1, Clam3, and Myh11, among the gene modules susceptible to stimuli. The regulatory element SUZ12 was associated with differential gene expression between stimuli in both sexes, whereas RELA and IRF1 were uniquely detected in males and females, respectively. The findings from the multifaceted approach provide genomic leads to investigating interventions that can mitigate the effects of stimuli on the amygdala function.

PMID:40991843 | DOI:10.1111/gbb.70036

Interdiscip Cardiovasc Thorac Surg. 2025 Sep 24:ivaf225. doi: 10.1093/icvts/ivaf225. Online ahead of print.

ABSTRACT

OBJECTIVES: In cardiovascular surgery, frailty is a risk for postoperative dysphagia. This study investigated the effect of preoperative training on strengthening the tongue muscle and its clinical impact.

METHODS: Patients scheduled for cardiovascular surgery between 2022 and 2024 who underwent preoperative tongue pressure measurement were included. Preoperative tongue muscle training was conducted using the novel device Pecopanda.

RESULTS: Forty-two patients who purchased the Pecopanda and received preoperative training were assigned to the training group, and 66 patients without training or with maintained tongue pressure were assigned to the non-training group. Low tongue pressure below 30 kPa was observed in 44.4% of patients. Age was 76 (71-81) years in the training group and 70 (59-75) years in the non-training group. Change in tongue pressure pre- to post-operation was 0.2 (IQR: -1.3 to 7.0) kPa in the training group, and -2.2 (IQR: -4.4 to -0.5) kPa in the non-training group. Multiple regression analysis showed that changes in tongue pressure pre- and post-operation tended to be greater in the training group (β = 1.342, 95% CI: -0.825 to 3.509). Logistic regression analysis suggested a trend towards a protective association between preoperative tongue training and deglutition diets or tube feeding at refeeding (OR = 0.81, 95% CI: 0.26 to 2.48). All patients in the training group were discharged home without the need for deglutition diets and tube feeding.

CONCLUSIONS: Preoperative training with simple tongue exercises may increase tongue pressure and support clinical outcomes in patients with low tongue pressure.

PMID:40991361 | DOI:10.1093/icvts/ivaf225

Brief Bioinform. 2025 Aug 31;26(5):bbaf487. doi: 10.1093/bib/bbaf487.

ABSTRACT

A gene is defined as essential when its functional loss compromises an organism’s viability. Identifying essential genes is critical for identifying the components that regulate a biological system. Advances in gene editing techniques like CRISPR-Cas9 provide a capacity to interrogate a genome to elucidate the genes that are essential. However, these techniques are often applied for a single-cell line and rarely probed at a level of a tissue or organ. The recent availability of large-scale single-cell RNA-sequencing (scRNA-seq) atlases provides an unprecedented opportunity to investigate essential gene expression in a more comprehensive context. Our study leverages information from benchmarking datasets, single-cell tissue atlases, and databases of essential genes, to develop a method, scEssentials, that uses a statistical framework to investigate the robustness and specificity of essential genes across multiple cell types. Using scEssentials, mouse and human models showed consistently high expression and exhibited limited variability across more than 60 cell types. We demonstrate a substantial number of significantly correlated gene pairs that produce densely connected co-expression networks with functional annotation. Finally, we develop a score to quantify the relative essentiality of genes within scEssentials, further validating their significant association with gene mutation frequency and chromatin accessibility. Using ageing as an application, we demonstrate how scEssentials identifies robust gene expression profiles. Only one-fifth of scEssentials genes showed significant ageing-related differential expression among age groups. Collectively, the robustness of scEssentials serves as a reference for analysing scRNA-seq data and provides insight into the heterogeneous nature such as ageing.

PMID:40991328 | DOI:10.1093/bib/bbaf487

Bioinformatics. 2025 Sep 24:btaf540. doi: 10.1093/bioinformatics/btaf540. Online ahead of print.

ABSTRACT

SUMMARY: Polygenic risk scores (PRSs) are essential tools for predicting individual phenotypic risk but often lack accuracy in non-European ancestry groups. Transfer Learning for Polygenic Risk Scores (TL-PRS) addresses this challenge by leveraging European PRSs to improve prediction in underrepresented ancestries but requires privacy-sensitive individual-level data and has low computational efficiency. Therefore, we introduce PTL-PRS (Pseudovalidated Transfer Learning for PRS), an extension of TL-PRS that incorporates pseudovalidation to eliminate the need for individual-level data and includes further software optimization. For pseudovalidation, PTL-PRS generates pseudo-summary statistics for training and validation and evaluates model performance with the pseudo-R2 metric. To improve computational efficiency, PTL-PRS software was optimized with C ++, blockwise early stopping, and direct genotype retrieval. Overall, PTL-PRS enhances usability while maintaining TL-PRS’s predictive performance.

AVAILABILITY AND IMPLEMENTATION: The PTL.PRS R package is publicly available on GitHub at https://github.com/bokeumcho/PTL.PRS. The summary statistics used in this paper are available in the public domain: UK Biobank (https://pheweb.org/UKB-TOPMed), PGS Catalog (https://www.pgscatalog.org), COVID-19 Host Genetics Initiative (https://www.covid19hg.org) and GenOMICC (https://genomicc.org/data).

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:40991324 | DOI:10.1093/bioinformatics/btaf540