Category: Nevin Manimala

J Am Coll Health. 2025 Jul 9:1-9. doi: 10.1080/07448481.2025.2519375. Online ahead of print.

ABSTRACT

OBJECTIVE: Explore student experience of campus green space, examining its connections to race and ethnicity, sexual orientation, welcomeness and housing type.

PARTICIPANTS: Undergraduate students at a state university who completed an online survey (n = 387) and focus groups (n = 9) in Fall 2022.

METHODS: Mixed methods approach, using SPSS for quantitative analysis and thematic analysis of long-response survey questions and focus groups for qualitative data.

RESULTS: Quantitative tests revealed a significant relationship between feeling welcome and use as well as type of housing and use. Although there are no statistically significant trends based on race, ethnicity and sexual orientation, qualitative data revealed their hesitance to use campus greenspace.

DISCUSSION: Campus green space can be used to evaluate levels of wellbeing and belonging on campus. Given the proven positive effects of greenspace, findings can inform discourse on wellbeing, belonging, and adapting greenspace so that students are encouraged to engage in it more.

PMID:40633050 | DOI:10.1080/07448481.2025.2519375

Hum Vaccin Immunother. 2025 Dec;21(1):2515760. doi: 10.1080/21645515.2025.2515760. Epub 2025 Jul 9.

ABSTRACT

Pneumococcal disease (PD) is associated with high morbidity and mortality, specifically among individuals ≥65 years of age and those with underlying medical conditions (UMCs). This retrospective cohort study estimated the clinical burden of PD in adults ≥18 years of age with or without UMCs in France. Data were obtained from the French National Health Data System for four yearly cohorts (1 January 2015-31 December 2018). Characteristics of patients with UMCs, with or without PD (UMC population), and the incidence rate and lethality rate of PD leading to hospitalization (in-patient PD population), stratified by age and risk status, were described. In the UMC population (n = 7,947,622; mean age: 65 years), the incidence rate of in-patient PD episodes was 121.98 per 100,000 person-years and was highest among individuals ≥65 years of age (138.52) and in those considered medium-risk (102.45) or high-risk (165.77). In the in-patient PD population (n = 41,885), 59.6% were ≥65 years of age; 1-year all-cause mortality following the initial in-patient PD episode was 26.5%. Individuals ≥65 years of age (regardless of risk status) had a higher risk of PD leading to hospitalization than individuals 18-64 years of age. This study shows a high burden of PD in France due to in-patient PD among adults with UMCs, particularly in those ≥65 years of age, despite their eligibility for pneumococcal vaccination. This highlights the need for higher vaccination coverage, supported by the recent extension of vaccination to all people ≥65 years of age, regardless of their health risk status.

PMID:40633023 | DOI:10.1080/21645515.2025.2515760

Am J Public Health. 2025 Aug;115(8):1222-1225. doi: 10.2105/AJPH.2025.308125.

ABSTRACT

Unconditional cash interventions, such as guaranteed income, are a proposed solution for mediating the adverse health outcomes associated with financial scarcity. To test this, the City of Los Angeles, California, conducted a mixed-methods, randomized controlled trial in which they gave 3202 people $1000 with no strings attached for 12 months in 2022. Although the quantitative findings demonstrated mixed health effects, the qualitative findings highlighted how recipients viewed their well-being as an insurance policy against scarcity and reallocated time to preventive health behaviors when receiving a guaranteed income. (Am J Public Health. 2025;115(8):1222-1225. https://doi.org/10.2105/AJPH.2025.308125).

PMID:40633007 | DOI:10.2105/AJPH.2025.308125

Retina. 2025 Jul 3. doi: 10.1097/IAE.0000000000004602. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the efficacy of serial intravitreal methotrexate (MTX) injections as an adjunct to surgical repair in the management of recurrent rhegmatogenous retinal detachment (rRRD) due to proliferative vitreoretinopathy (PVR).

METHODS: A retrospective cohort study was conducted involving 41 eyes with a history of failed RRD repair presenting with rRRD and grade C1 to D PVR, treated with pars plana vitrectomy (PPV) and serial MTX injections were included, separated into group 1 (with modified GUARD protocol, n=27) and group 2 (without modified GUARD protocol, n=14). The primary outcome was retinal reattachment rate, and secondary outcomes were changes in visual acuity and postoperative complications.

RESULTS: Retinal reattachment was achieved without additional surgery in 21 (77.8%) eyes in group 1 and 10 (71.4%) in group 2 at final follow-up, with no statistical significance. Improvement in logMAR was 0.50 in group 1 and 0.44 in group 2, with a median follow-up of 12.1 months from surgery and no differences in postoperative complications.

CONCLUSION: There were no differences in retinal reattachment or visual acuity outcomes between both methotrexate regimens. The overall reattachment rate exceeded previously reported rates for rRRD with PVR. Further research is needed to optimize the injection protocol for better clinical outcomes.

PMID:40632995 | DOI:10.1097/IAE.0000000000004602

J Am Acad Orthop Surg Glob Res Rev. 2025 Jul 8;9(7). doi: 10.5435/JAAOSGlobal-D-25-00175. eCollection 2025 Jul 1.

ABSTRACT

INTRODUCTION: Total joint arthroplasty (TJA) is evolving with new technologies and techniques introduced in fellowship training, but the effect on surgeons’ future practices remains unclear. We assessed current practice patterns and influential factors among fellowship-trained arthroplasty surgeons.

METHODS: An electronic survey was sent to all currently practicing surgeons (n = 90) who had completed a high-volume adult reconstruction fellowship at a single tertiary academic center from 1986 to 2022. The survey consisted of 73 questions regarding surgeon and practice characteristics for primary and revision total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty. Data were tabulated and analyzed in REDCap software.

RESULTS: The survey was completed by 53 surgeons (59%): 46% had been in practice for 0 to 5 years, 32% for 6 to 10 years, and 21% for 11 to 20 years. Overall, 81% performed at least 100 THAs, and 77% performed at least 150 TKAs annually. Revision TJA constituted 0% to 20% of surgical practice for 70% of surgeons, whereas 30% performed revision TJA in 21% to 40% of cases. The most common approach for THA was direct anterior (28/53, 53%), followed by posterior (22/53, 42%). Fellowship experience was the most influential factor on the choice of THA approach (57%), as well as on the choice of THA (64%) and TKA (57%) implants. Among surgeons with access to robots, 52% did not perform any robotic THAs, whereas 27% performed more than 80% of their THAs robotically. By contrast, 64% of surgeons performed more than 80% of their primary TKAs robotically, and only 13% did no robotic TKAs despite having access to a robot.

CONCLUSION: Fellowship experience was the primary factor influencing approach and implant choices in both THA and TKA, highlighting its notable effect on shaping trainees’ future practices. Therefore, fellowship programs should offer exposure to diverse technologies and techniques to enable informed decision making.

PMID:40632991 | DOI:10.5435/JAAOSGlobal-D-25-00175

J Clin Oncol. 2025 Jul 9:JCO2402697. doi: 10.1200/JCO-24-02697. Online ahead of print.

ABSTRACT

PURPOSE: We investigated breastfeeding patterns, behaviors, and association with breast cancer (BC) outcomes in women with early hormone receptor-positive (HR+) BC who had a live birth in the POSITIVE trial.

PATIENTS AND METHODS: POSITIVE is a prospective trial that demonstrated no increased short-term risk of BC events in women with early HR+ BC who interrupted endocrine therapy (ET) to attempt pregnancy. We describe the frequency, duration, and laterality of breastfeeding and estimate the cumulative incidence of BC events by breastfeeding status.

RESULTS: At a median follow-up of 41 months, 317 patients had at least one live birth and 313 were eligible for this analysis. A total of 196 of 313 (62.6%) patients breastfed. A total of 130 of the 167 women (77.8%) who had breast-conserving surgery breastfed, and 90 of 130 (69.2%) breastfed from the unaffected breast only. Sixty-six of the 146 women (45.2%) who underwent unilateral mastectomy breastfed. The frequency of breastfeeding was higher in women older than 35 years (67.6% v 55.7%) and in those without previous children (66.4% v 48.5%). Over half (103 of 196, 52.6%) of women breastfed their first live birth for >4 months (median 4.4 months; 95% CI, 4.0 to 5.3). The cumulative incidence of a BC event at 24 months from first on-study live birth was 3.6% and 3.1% in the breastfeeding and nonbreastfeeding groups, respectively (0.5% difference; 95% CI, -4.3% to 5.2%).

CONCLUSION: In POSITIVE, two thirds of women who gave birth after BC diagnosis breastfed, mostly for 4 months or more. In early follow-up, we did not observe differences in BC-related events in women who breastfed compared with those who did not. These results are key for women who wish to pursue pregnancy and breastfeeding after BC.

PMID:40632989 | DOI:10.1200/JCO-24-02697

Neurology. 2025 Aug 12;105(3):e213829. doi: 10.1212/WNL.0000000000213829. Epub 2025 Jul 9.

ABSTRACT

BACKGROUND AND OBJECTIVES: Geographic disparities in stroke clinical trials may limit access to innovative treatments in high-burden regions. This study examines the distribution of completed stroke trials (2010-2020) relative to stroke mortality and hospitalization rates.

METHODS: Data on completed trials were obtained from ClinicalTrials.gov and stroke burden metrics from the Control and Prevention. We calculated relative study frequency (RSF) by dividing the number of stroke deaths, age-adjusted stroke death rates, and stroke hospitalizations per 100,000 Medicare beneficiaries by the number of available trials. RSF values were stratified by quartiles.

RESULTS: A total of 649 stroke-related clinical trials were completed across 40 states, with 10 states having no registered trials. RSF varied widely, with the lowest quartile, including Mississippi (RSF = 14.40) and Louisiana (RSF = 13.90), having high stroke hospitalizations with minimal research activity, while California (RSF = 0.09) and New York (RSF = 0.19) had greater clinical trial availability to address stroke burden.

DISCUSSION: Stroke trial availability is disproportionately low in high-burden regions, particularly in the Southeast and Midwest. States with high stroke mortality and hospitalization rates but low clinical trial availability may face barriers to trial access, potentially exacerbating disparities in stroke care.

PMID:40632981 | DOI:10.1212/WNL.0000000000213829

JCO Precis Oncol. 2025 Jul;9:e2500200. doi: 10.1200/PO-25-00200. Epub 2025 Jul 9.

ABSTRACT

PURPOSE: Although deep targeted DNA sequencing of liquid biopsies has shown prognostic utility in large B-cell lymphoma (LBCL), the routine clinical adoption of these assays remains limited because of their high costs.

MATERIALS AND METHODS: Here, leveraging a well-annotated cohort encompassing both frontline and relapsed/refractory (R/R) LBCL, we profiled patient plasma samples with two complementary modalities-ultra-low-pass whole-genome sequencing (ULP-WGS) and deep targeted DNA sequencing, the former being a cost-effective method to profile large scale chromosomal abnormalities and estimate tumor burden.

RESULTS: Our findings revealed a strong association of high cell-free tumor burden by both genomic profiling modalities with established measures of tumor burden and patient survival. Notably, the associations with survival remained statistically significant after accounting for international prognostic index scoring. Furthermore, we showed that del(17p) in circulating tumor DNA as detected by ULP-WGS was strongly associated with TP53 mutation status and predicted for significantly inferior outcome in frontline LBCL patients but not in patients with R/R LBCL.

CONCLUSION: Our study demonstrates that ULP-WGS can provide robust prognostic biomarkers for both frontline and R/R LBCL, highlighting its broad applicability for risk stratification.

PMID:40632977 | DOI:10.1200/PO-25-00200

J Am Acad Orthop Surg Glob Res Rev. 2025 Jul 9;9(7). doi: 10.5435/JAAOSGlobal-D-25-00194. eCollection 2025 Jul 1.

ABSTRACT

INTRODUCTION: Anterior cruciate ligament (ACL) injuries are relatively common in the pediatric population, and ACL reconstruction (ACLR) followed by postoperative physical therapy (PT) is frequently considered to decrease the risk of additional knee injury and improve functional outcomes. Disparities across insurance groups in ACL surgical rates and PT utilization have been previously reported, but there is limited analysis from national databases, and even less about disparity trends over time.

METHODS: The 2015 to 2020 M157 PearlDiver database was queried for patients younger than 18 years diagnosed with ACL injury with commercial or Medicaid insurance. Factors abstracted included year, insurance plan, ACLR or not, and PT utilization and number of visits. The incidence of ACLR and PT visits were compared across insurance groups by year.

RESULTS: In total, 61,333 ACL injuries were identified for which ACLR was done for 21,083 (34.4%). The incidence of reconstruction was higher for those with commercial than Medicaid (35.0% vs. 30.7%, P < 0.001). Over the years of the study, this gap decreased from 7.7% in 2015 (P < 0.001) to 0.7% in 2020 (P = 0.714). For postoperative patients, those with commercial insurance had more PT sessions (26.45 vs. 22.53, P < 0.001). This gap decreased from 6.48 sessions in 2015 (P < 0.001) to 4.07 sessions in 2020 (P = 0.002). For nonsurgical patients, those with commercial insurance were more likely to receive PT (43.3% vs. 39.8%, P < 0.001) and to receive more sessions (18.76 vs. 14.35, P < 0.001). The gap in PT incidence deceased from 9.7% in 2015 (P < 0.001) to 2.4% in 2020 (P = 0.200).

CONCLUSION: Medicaid pediatric patients with ACL injuries were markedly less likely to undergo reconstruction and received less PT than commercial insurance patients, but these differences decreased/disappeared over the years studied. It is reassuring to see these insurance-related disparities decreasing over time, and continued access efforts are needed.

PMID:40632971 | DOI:10.5435/JAAOSGlobal-D-25-00194

JCO Clin Cancer Inform. 2025 Jul;9:e2400234. doi: 10.1200/CCI-24-00234. Epub 2025 Jul 9.

ABSTRACT

PURPOSE: Previous studies have consistently reported disparities in electronic health record portal enrollment. Among patients enrolled in a portal, it is less clear whether there are disparities in usage. We investigated whether disparities existed in portal usage among enrolled oncology patients regarding both sending portal messages to and receiving messages from oncology providers.

METHODS: This retrospective cohort study included patients ≥18 years old with cancer who were seen at an urban academic cancer center between January 2011 and February 2025 and enrolled in the patient portal. We developed Cox proportional hazards models for the outcomes of patients sending portal messages to and receiving messages from oncology providers as the first message in a thread. Time measurement began with the first cancer center visit or portal enrollment, whichever was later. Models were adjusted for demographic, socioeconomic, disease, and administrative visit variables.

RESULTS: Among 101,678 patients, the median age was 62 years (IQR, 51-71), and 68,527 sent and 42,242 received messages. After adjustment, age ≥50 versus 18-29 years, Latinx and Pacific Islander versus White, single and widowed versus partnered, non-English preferred language, and Medicaid and Medicare versus private insurance were associated with reduced likelihood of sending and receiving messages. Black and American Indian/Alaska Native were associated with reduced likelihood of sending messages. Female provider was associated with increased likelihood of sending and receiving messages. Women were more likely to send messages.

CONCLUSION: Among oncology patients enrolled in the patient portal, disparities existed in sending and receiving portal messages. Given the association of messaging with better survival among oncology patients in previous studies, future studies should determine how best to minimize messaging disparities beyond just addressing disparities in portal enrollment.

PMID:40632947 | DOI:10.1200/CCI-24-00234