Category: Nevin Manimala

Gigascience. 2025 Jan 6;14:giaf082. doi: 10.1093/gigascience/giaf082.

ABSTRACT

BACKGROUND: Lateralization is the asymmetry in function and cognition between the brain hemispheres, with notable sex differences. Conventional neuroscience studies on lateralization use univariate statistical comparisons between male and female groups, with limited and ineffective validation for group specificity. This article proposes to model sex differences in brain functional network lateralization as a dual-classification problem: first-order classification of left versus right hemispheres and second-order classification of male versus female models. To capture sex-specific patterns, we developed an interpretable group-specific discriminant analysis (GSDA) for first-order classification, followed by logistic regression for second-order classification.

FINDINGS: Evaluations on 2 large-scale neuroimaging datasets show GSDA’s effectiveness in learning sex-specific patterns, significantly improving model group specificity over baseline methods. Major sex differences were identified in the strength of lateralization and interaction patterns within and between lobes.

CONCLUSIONS: The GSDA-based analysis challenges the conventional approach to investigating group-specific lateralization and indicates that previous findings on sex-specific lateralization will need revisits and revalidation. This method is generic and can be adapted for other group-specific analyses, such as treatment-specific or disease-specific studies.

PMID:40884801 | DOI:10.1093/gigascience/giaf082

JAMA Cardiol. 2025 Aug 30. doi: 10.1001/jamacardio.2025.3403. Online ahead of print.

ABSTRACT

IMPORTANCE: Mounting evidence suggests transcatheter aortic valve implantation (TAVI) as preferred treatment for patients at low to intermediate surgical risk. However, limitations in study design and statistical power raise concerns about the generalizability of individual randomized clinical trials (RCTs) comparing TAVI and surgical aortic valve replacement (SAVR) to routine clinical practice.

OBJECTIVE: To compare 1-year outcomes of TAVI vs SAVR in patients with severe symptomatic aortic stenosis at low to intermediate surgical risk applying a 2-stage individual participant data (IPD) and aggregate meta-analyses.

DATA SOURCES: MEDLINE databases were searched for RCTs comparing TAVI and SAVR in patients with aortic stenosis until June 15, 2025.

STUDY SELECTION: RCTs were selected comparing TAVI vs SAVR in patients with severe symptomatic aortic stenosis at low or intermediate surgical risk with 1-year follow-up.

DATA EXTRACTION AND SYNTHESIS: IPD were obtained from all investigator-initiated RCTs (DEDICATE, NOTION, NOTION-2, and UK TAVI) and analyzed in 1- and 2-stage IPD meta-analyses. An overall meta-analysis was performed by adding aggregate data from industry-sponsored RCTs.

MAIN OUTCOMES AND MEASURES: The primary end point was all-cause death or any stroke 1 year after randomization. Secondary end points included all-cause death, any stroke, disabling stroke, cardiovascular death, rehospitalization for cardiovascular cause, myocardial infarction, new-onset atrial fibrillation, new permanent pacemaker implantation, and aortic valve reintervention.

RESULTS: The IPD meta-analysis included 4 RCTs comprising 2873 patients (mean [SD] age, 76.7 [5.5] years; 805 [56.1%] male) at low to intermediate surgical risk randomly assigned to TAVI (n = 1439) or SAVR (n = 1434). At 1 year, the hazard ratio (HR) for the primary end point for TAVI compared to SAVR was 0.73 (95% CI, 0.56-0.95) in the 1-stage and 0.79 (95% CI, 0.49-1.27) in the 2-stage IPD meta-analysis. In the 2-stage overall meta-analysis the HR for the primary end point was 0.76 (95% CI, 0.60-0.97).

CONCLUSIONS AND RELEVANCE: In this IPD meta-analysis of 4 RCTs, and an overall meta-analysis of 8 RCTs of patients with severe symptomatic AS at low to intermediate risk, TAVI was associated with a reduction in the 1-year incidence of all-cause death or any stroke. These findings emphasize TAVI as alternative option in patients at low to intermediate risk. Long-term follow-up is warranted to evaluate sustainability of these findings.

PMID:40884787 | DOI:10.1001/jamacardio.2025.3403

Pediatr Hematol Oncol. 2025 Aug 30:1-11. doi: 10.1080/08880018.2025.2550516. Online ahead of print.

ABSTRACT

Children with relapsed acute lymphoblastic leukemia (ALL) face higher rates of infection and treatment-related mortality than at initial diagnosis. Although immunotherapy is increasingly used in the relapsed setting, combination intensive chemotherapy remains the standard approach for reinduction. Serious infections during this phase can delay or preclude curative therapy. We aimed to describe the incidence and pattern of infections during reinduction in this high-risk population. In this single-center retrospective study, we reviewed charts of patients with relapsed ALL treated with combination chemotherapy reinduction at British Columbia Children’s Hospital between 2006 and 2022. Forty-three patients were included (median age 10.2 years at relapse). Most (90%) received a standard four-drug reinduction. Median duration of severe neutropenia was 20.8 days. About half (51%) experienced at least one infection, including 16% with confirmed or probable fungal infection. Infection was associated with significantly longer hospitalization (median 17 vs. 7 days; p = 0.006). While no predictors reached statistical significance, hyperglycemia and neutropenia ≥ 21 days were associated with higher odds of infection. Overall survival did not differ significantly by infection status (log-rank p = 0.43). Infectious complications remain common during reinduction chemotherapy for relapsed ALL despite advances in supportive care. While pharmacologic and clinical strategies may reduce risk, safer and more targeted reinduction approaches are urgently needed to optimize outcomes in this vulnerable group.

PMID:40884783 | DOI:10.1080/08880018.2025.2550516

World J Surg. 2025 Aug 30. doi: 10.1002/wjs.70076. Online ahead of print.

ABSTRACT

BACKGROUND: Although open repair has historically been the preferred approach over laparoscopic repair for acutely strangulated and incarcerated groin hernias, the laparoscopic approach is gaining popularity. This systematic review and meta-analysis aims to investigate the safety and clinical outcomes of laparoscopic and open groin hernia repair in the emergency setting.

METHODS: PubMed, Embase, Scopus, Cochrane Library, and Web of Science were systematically searched for articles comparing clinical outcomes between laparoscopic and open emergency groin hernia repair in adult patients. The primary outcome was the length of hospital stay. Secondary outcomes included operative time, postoperative complications, recurrence, reoperation, postoperative mortality, and the rate of conversion from laparoscopic to open repair. Risk of bias was assessed.

RESULTS: Thirteen articles (4 prospective and 9 retrospective cohort studies) were included, with a total of 38,659 patients enrolled. Laparoscopic repair resulted in shorter length of hospital stay (MD -2.96 days [95% CI -4.91, -1.01] and p = 0.0074) and lower risk of wound infection (RR 0.29 [95% CI 0.20, 0.43] and p < 0.0001]. No statistically significant differences were observed between the two groups regarding operative time (p = 0.1006), risk of seroma formation (p = 0.3142), and risk of respiratory complication (p = 0.9880). Rate of conversion from laparoscopic to open repair as recorded in five studies was 2.78% ([95% CI 0.60, 11.92]).

CONCLUSION: Emergency laparoscopic repair of groin hernias results in shorter length of hospital stay and lower risks of postoperative morbidity and mortality, with no difference in operative time when compared to open repair. Although further large-scale prospective cohort studies and randomized controlled trials may be required to draw definitive conclusionsregarding the optimal surgical approach, laparoscopic repair of groin hernias appears to be a safe and feasible alternative to conventional open repair in the acute setting.

PMID:40884778 | DOI:10.1002/wjs.70076

J Asthma. 2025 Aug 30:1-12. doi: 10.1080/02770903.2025.2555301. Online ahead of print.

ABSTRACT

Despite the health benefits of physical activity (PA), many individuals with asthma are not sufficiently active. Wearable devices (WD) are increasingly popular tools for promoting PA, but limited research has examined their effectiveness among individuals with asthma. This study aims to compare PA levels between WD users and non-users with asthma. Data were drawn from the 2017 Behavioral Risk Factor Surveillance System. Participants who self-reported a diagnosis of asthma were included in this secondary data analysis. Based on the self-report, participants were categorized as WD users or non-users. PA measures included total weekly minutes of PA, weekly minutes of vigorous PA, and whether participants met national PA guidelines. Survey-weighted unadjusted and adjusted linear and logistic regression analyses were conducted to assess associations between WD use and PA outcomes. Among the included 497 participants with asthma, 28.19% (95% CI [19.36, 38.30]) of participants were WD users and 71.81% (95% CI [61.7, 80.64]) were non-users. 65.91% (95% CI [57.36, 73.82]) of the participants met the PA guidelines. The unadjusted and adjusted linear regressions found no statistically significant differences in weekly PA and weekly vigorous PA between WD users and non-users. Further, no statistically significant associations were found between WD usage and meeting PA guidelines (p > .05). WD use was not associated with higher PA levels among individuals with asthma. Further research is needed to identify strategies that enhance the effectiveness of WD in promoting PA in this population.

PMID:40884769 | DOI:10.1080/02770903.2025.2555301

Circulation. 2025 Aug 30. doi: 10.1161/CIRCULATIONAHA.125.076678. Online ahead of print.

ABSTRACT

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly performed in younger, low surgical risk patients. This NOTION-2 study reports mid-term outcomes in low-risk patients aged 60-75 years with severe tricuspid or bicuspid aortic stenosis (AS) undergoing TAVR or surgical valve replacement.

METHODS: A total of 370 patients (mean age 71.1 years, mean Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM] 1.2%) were enrolled and randomized 1:1 to TAVR or surgery. This follow-up study reports clinical and echocardiographic outcomes up to three years of follow-up.

RESULTS: At three years, the primary composite endpoint (death, stroke, or procedure-, valve, or heart failure-related hospitalization) occurred in 16.1% of TAVR patients vs. 12.6% in surgical patients (hazard ratio [HR] 1.3; 95% confidence interval [CI]: 0.8 – 2.2%; P=0.4). Among patients with tricuspid AS, rates were similar (14.5% vs. 14.4%), while bicuspid AS patients had a statistical non-significant higher risk with TAVR (20.4% vs. 7.8%; HR 2.9; 95% CI: 0.9 – 9.0). The risk of moderate or greater structural valve deterioration at three years was 4.5% and 5.2% for transcatheter and surgical aortic bioprostheses, respectively (HR 1.2; 95% CI: 0.4-3.1). Bioprosthetic valve failure rates were also comparable: 1.6% in the TAVR and 2.9% in the surgical group.

CONCLUSIONS: For patients aged 60-75 years with severe AS who are at low surgical risk, three-year clinical outcomes are similar between TAVR and surgery. Both procedures are associated with low rates of structural valve deterioration and need for re-intervention.

PMID:40884768 | DOI:10.1161/CIRCULATIONAHA.125.076678

Environ Monit Assess. 2025 Aug 30;197(9):1065. doi: 10.1007/s10661-025-14500-w.

ABSTRACT

In this study, the water quality index (WQI) was calculated using multivariate statistics, incorporating physical, chemical, and microbiological analysis of water samples taken from water supply networks in the western district of Tehran from 2021 to 2024. The principal drinking water parameters such as pH, total hardness, turbidity, lead (Pb), chloride (Cl), fluoride (F), total dissolved solids (TDS), sulfate (SO₄), nitrate (NO₃), nitrite (NO₂), calcium (Ca), magnesium (Mg), arsenic (As), mercury (Hg), cadmium (Cd), fecal coliform and total residual chlorine (Ch) were selected according to Iranian national water standards. The WQI index was predicted using various machine learning algorithms, including multiple linear regression (MLR), support vector machine (SVM) regression, extreme gradient boosting (XGBoost), Random Forest (RF) regression, multilayer perceptron (MLP), and Kolmogorov-Arnold networks (KAN). The results showed that the traditionally computed WQI values ranged from 75 to 86, indicating that water quality varied from fair to good for drinking purposes. The prepared WQI maps revealed that the water quality of 71% of the evaluated areas between 2021 and 2022 was in the good range, whereas the water quality of 50% and 87% of the locations was rated as good in the subsequent years. Moreover, excellent prediction results were obtained, with an R² of 0.901 and root mean squared error (RMSE) of 0.286 for the MLP model, and an R² of 0.9527 and RMSE of 0.197 for the KAN model. The results obtained indicate that both the KAN and MLP models are effective for accurately predicting the WQI.

PMID:40884733 | DOI:10.1007/s10661-025-14500-w

Cell Biochem Biophys. 2025 Aug 30. doi: 10.1007/s12013-025-01837-9. Online ahead of print.

ABSTRACT

Oxidized low-density lipoprotein (OxLDL) is increasingly recognized as a critical mediator in the pathogenesis of atherosclerosis and several chronic diseases, including type 2 diabetes, metabolic syndrome, Alzheimer’s disease, and chronic kidney disease. Given the biochemical heterogeneity of OxLDL, its accurate quantification remains a significant analytical challenge for precise statistical and Machine Learning (ML) methods. The paper examines statistical and computational methodologies used to assess OxLDL levels in clinical studies, highlighting strengths, limitations, and clinical relevance. This contribution provides current insights on standardizing analytic pipelines using statistical and machine learning tools for reproducibility, interpretability, and translational impact in clinical research. Traditional statistical methods have provided a foundational understanding of OxLDL’s clinical implications. Meta-analyses, regression models, and survival analyses have consistently demonstrated associations between elevated OxLDL levels and increased disease risk, severity, and mortality. Comparative analyses (t-tests, ANOVA) and correlation studies further reveal its links with inflammation, lipid profiles, and cardiac function. Emerging ML and Artificial Intelligence (AI) approaches offer powerful tools to advance OxLDL research. Predictive models using ML algorithms enhance disease risk stratification, while deep learning facilitates automated image analysis to assess OxLDL-induced vascular changes. AI-integrated diagnostic platforms now combine clinical, biochemical, and imaging data to improve outcome prediction in CVD.

PMID:40884728 | DOI:10.1007/s12013-025-01837-9

Intern Emerg Med. 2025 Aug 30. doi: 10.1007/s11739-025-04092-1. Online ahead of print.

ABSTRACT

The exact role of SIRT7 in hypertensive patients with coronary artery disease (CAD) remains elusive. This study aimed to explore plasma SIRT7 levels and their clinical significance in this population. From July 2022 to June 2024, 222 hypertensive patients (106 with isolated hypertension and 116 with hypertension plus CAD) were enrolled. Plasma SIRT7 was measured by ELISA, and participants were followed for rehospitalization (median 804 days). ROC curves, LASSO regression, and Cox proportional hazards models were used for statistical analysis. Hypertensive CAD patients had significantly higher SIRT7 levels than those without CAD (P < 0.001). Plasma SIRT7 levels were positively correlated with CK (R = 0.36, P < 0.001) and CK-MB (R = 0.50, P < 0.001), and negatively with HDL-C (R = -0.23, P < 0.001). The optimal cutoff of SIRT7 for diagnosing CAD demonstrated 94.0% sensitivity and 75.5% specificity, exhibiting an AUC of 0.917, superior to CK, CK-MB, and HDL-C. Multivariate analysis identified SIRT7 as an independent CAD risk factor (adjusted OR = 1.97, 95% CI 1.48-2.63). Restricted cubic spline (RCS) analysis revealed a linear correlation between SIRT7 and rehospitalization (P for overall = 0.038), but no non-linear relationship (P for non-linear = 0.164). Elevated SIRT7 predicted rehospitalization risk (HR = 1.15, 95% CI 1.02-1.29) and improved risk prediction, with an integrated discrimination index (IDI) of 21.8% and net reclassification improvement (NRI) of 51.0%. Plasma SIRT7 acts as both a diagnostic marker for CAD and a predictor of rehospitalization in hypertensive patients, indicating its dual role in pathogenesis and clinical monitoring. Targeting SIRT7 signaling may offer a new therapeutic strategy for hypertension-associated CAD.

PMID:40884727 | DOI:10.1007/s11739-025-04092-1