Tag: nevin manimala

Appl Bionics Biomech. 2025 Nov 10;2025:5951085. doi: 10.1155/abb/5951085. eCollection 2025.

ABSTRACT

Knee motion involves intricate coordination among various anatomical structures. Effective treatment of knee pathologies requires precise identification of deformities and accurate surgical interventions, which often involve rapid tissue modification based on established knowledge. However, motion disorders are typically detected long after surgery. To address this, a simulation environment is proposed to plan and analyze surgical impacts on knee motion. Comprehensive knee joint modeling is crucial for a successful simulation. Clinically accepted movement procedures based on passive knee motion make tibiofemoral articulation modeling sufficient. Proposed model tibiofemoral articulation, incorporating 15 ligaments, tibial and femoral bones, and cartilages. Ligaments’ tensile, bones’, and cartilages’ contact forces (CFs) define internal force interactions. Anatomical structures, their shapes, positions, and attachment points are identified from MRI, ensuring patient-specific modeling. Simulation results are compared to cadaver data using passive knee motion. Two rotational and three translational dependent joint motions (JMs) are compared pairwise. The results are highly correlated with the clinical benchmark. Pearson’s correlation show a strong association between experimental and simulated passive knee flexions (PKFs; r > 0.89). The comparison is statistically significant with p < 0.05. Anterior-posterior translation showed the highest correlation (R ² = 0.994). The findings indicate that the simulated model closely replicates actual knee responses.

PMID:41230427 | PMC:PMC12602475 | DOI:10.1155/abb/5951085

Orthop J Sports Med. 2025 Nov 7;13(11):23259671251386445. doi: 10.1177/23259671251386445. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Anterior cruciate ligament (ACL) tears can be a source of significant morbidity, with the potential for career-altering implications for athletes who sustain them. Specific knee biomechanics during a drop vertical jump have been shown to be associated with an increased risk for ACL injury in collegiate varsity athletes. Presently, the evolution of these kinematics from preseason to postseason is not well-understood.

PURPOSE: To compare preseason and postseason knee biomechanics during a drop vertical jump in collegiate varsity athletes and identify changes in ACL injury risk.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: A total of 114 collegiate athletes were prospectively enrolled. Of these 114, 67 athletes (male, 21 [31%]; female, 46 [69%]) completed properly captured preseason and postseason drop vertical jumps tracked by an affordable motion capture system. Initial coronal (IC), peak coronal (PC), and peak sagittal (PS) angles of the knee were compared between preseason and postseason using the Wilcoxon signed-rank test and paired-samples t test. Athletes at high risk for ACL injury were identified based on published cutoff angles: IC angle >2.96°, PC angle >6.16°, and PS angle <93.82°, then the distribution of these athletes was compared.

RESULTS: In male athletes, all preseason knee angles were in the low-risk range. At postseason, men presented a nonsignificant reduction in mean IC and PC knee angles and a nonsignificant reduction in mean PS angle (90.88 ± 10.69). On average, female athletes were at high risk at preseason according to mean IC and PS angles (4.24 ± 1.09 and 92.90 ± 6.94, respectively). There was a statistically significant reduction in mean IC angle (mean difference [MD], 2.23; P = .03) and mean PC angle (MD, 0.76; P = .04); however, mean IC angle remained in the high-risk range. There was a nonsignificant reduction in mean PS angle, which remained within the high-risk range (MD, 3.96; P = .24).

CONCLUSION: Our study demonstrated that female collegiate varsity athletes demonstrate higher risk knee biomechanics in comparison with their male counterparts. Even with improved biomechanics as their season advances, female athletes have a persistently low PS angle, leaving them at high risk of ACL injury. Using a portable and reliable motion capture system may facilitate monitoring knee kinematics, which could translate into a tool for ACL injury prevention in athletes.

PMID:41230424 | PMC:PMC12602941 | DOI:10.1177/23259671251386445

Orthop J Sports Med. 2025 Nov 10;13(11):23259671251389142. doi: 10.1177/23259671251389142. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Scheduled follow-up (FU) appointments are a vital element of monitoring patient progress and outcomes. However, failure to attend FU appointments continues to be a regular problem in orthopaedics.

PURPOSE: To investigate the relationship between FU appointment attendance and functional outcomes after hip arthroscopy.

STUDY DESIGN: Cohort Study; Level of evidence, 3.

METHODS: A retrospective analysis of prospectively collected data was conducted in patients who underwent primary hip arthroscopy for symptomatic labral tears between 2014 and 2023. FU attendance after suture removal was used to categorize patients into 2 cohorts based on whether they attended all standard FU appointments (AA) or missed at least 1 FU appointment (MAO) at 3-, 6-, or 12-month intervals. Patient-reported outcome measures (PROMs) included the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Activities of Daily Living, HOS-Sports Specific Subscale, 33-item International Hip Outcome Tool, and patient satisfaction.

RESULTS: Overall, 178 hips (54.5% women) met the inclusion criteria, with 110 hips (mean age, 35.9 ± 10.6 years) in the AA cohort and 68 hips (mean age, 35.1 ± 11.8 years) in the MAO cohort. Both groups had similar radiographic and demographic characteristics, except for the distribution of Asian and White patients (18 vs 3 and 44 vs 100, respectively; P < .001). PROMs were statistically similar at all time points (P > .05). Multivariate linear regression model analyses showed no differences after adjusting for cohort, distance from clinic, sex, race, and age for all PROMs. Additionally, both cohorts achieved clinically meaningful outcomes (CMOs) at similar rates (P > .05).

CONCLUSION: Patients who missed at least 1 FU appointment achieved similar improvements in functional outcomes compared with those who attended all. Both cohorts achieved minimal clinically important difference, patient acceptable symptom score, and significant clinical benefit at comparably high rates. These findings suggest that functional outcomes are not associated with FU appointment attendance. Additionally, those who do not attend all of their postoperative FU appointments can still achieve CMOs.

PMID:41230422 | PMC:PMC12603001 | DOI:10.1177/23259671251389142

J Pharm Health Care Sci. 2025 Nov 12;11(1):99. doi: 10.1186/s40780-025-00504-8.

ABSTRACT

BACKGROUND: A team-based approach is essential to provide cancer patients with high-quality treatment. To ensure the best possible care while reducing the workload of physicians, Ehime University Hospital has introduced three protocol-based pharmacotherapy management (PBPM) strategies in the field of chemotherapy. First, we introduced PBPM to avoid reactivation of hepatitis B virus (HBV) in patients receiving immunosuppressive therapy or chemotherapy. In this PBPM strategy, pharmacists added laboratory test orders for patients who require regular HBV-DNA quantification (HBV-PBPM). Second, we devised PBPM for measurement of the urine protein/creatinine ratio (UPC) in patients receiving anti-vascular endothelial growth factor therapy. Finally, we introduced PBPM for measurement of serum magnesium in patients receiving anti-epidermal growth factor receptor antibody therapy (Mg-PBPM). In this study, we evaluated the usefulness of these three PBPM strategies in outpatients receiving chemotherapy.

METHODS: The study included patients treated in the outpatient chemotherapy unit between July 2021 and February 2023. Rates of compliance with laboratory tests in the 6 months before and after introduction of PBPM were compared.

RESULTS: Compliance with HBV-DNA quantification improved significantly from 66.3% before PBPM to 86.7% after implementation of PBPM (p = 0.002). The median duration of noncompliance was significantly shorter after initiation of PBPM (p = 0.021). Compliance with measurement of UPC was already greater than 95% before PBPM and showed no change after implementation (98.7% pre-PBPM vs 99.3% post-PBPM). Compliance with measurement of serum magnesium improved from 95.8% pre-PBPM to 99.2% after starting PBPM, but the improvement was not statistically significant.

CONCLUSIONS: Introduction of PBPM improves compliance with the laboratory tests required in cancer patients during chemotherapy and enables safer delivery of treatment.

PMID:41225546 | DOI:10.1186/s40780-025-00504-8

BMC Musculoskelet Disord. 2025 Nov 12;26(1):1040. doi: 10.1186/s12891-025-09280-w.

ABSTRACT

OBJECTIVE: Bisphosphonates and denosumab can increase bone mineral density (BMD) and are used to treat osteoporosis caused by aromatase inhibitors (AIs). However, few studies have been conducted on the effects of both on vertebral compression fractures (VCFs). This article aims to compare the effects of alendronate sodium and denosumab injection on the frequency of VCFs in postmenopausal women whose osteoporosis was brought on by AIs treatment for breast cancer.

METHODS: A retrospective cohort study was conducted from January 2020 to December 2024, enrolling 121eligible breast cancer patients with aromatase inhibitor-associated osteoporosis from the orthopedic outpatient department of Foshan Hospital of Traditional Chinese Medicine. Patients were divided into two treatment groups: the alendronate group received oral alendronate sodium tablets (70 mg once weekly), while the denosumab group received subcutaneous denosumab injections (60 mg every 6 months). Both groups were supplemented with calcitriol and calcium carbonate/vitamin D3 tablets as baseline therapy. The observation period was 12 months. The following parameters were compared between the two groups before and after treatment: BMD, 25-hydroxy Vitamin D3 (25-OH D3), β-C-terminal telopeptide of type I collagen (β-CTX) and Procollagen I N-Terminal Propeptide (PINP), Visual Analog Scale (VAS) scores and Incidence of VCFs. Statistical analysis was performed using SPSS 27.0.

RESULTS: The study included a total of 121 patients. Post-treatment analysis revealed a significantly higher overall response rate in the denosumab group(n = 57) (91.22%) compared to the alendronate group(n = 64) (82.81%; P < 0.05). Notably, the denosumab group demonstrated superior outcomes in the following two areas: (1) significantly greater improvement in BMD, (2) lower incidence of vertebral compression fractures (both P < 0.05). Both treatment groups showed statistically significant improvements in bone metabolism markers following treatment (P < 0.01).

CONCLUSION: Both therapeutic regimens effectively improved BMD in the study population. However, comparative analysis revealed that denosumab injection (60 mg every 6 months) demonstrated significant advantages over weekly alendronate sodium (70 mg) in multiple clinical outcomes. Specifically, the denosumab group showed: (1) greater BMD improvement at all measured skeletal sites, and (2) a significantly lower incidence of VCFs (all P < 0.05) in postmenopausal women with aromatase inhibitor-associated osteoporosis.

PMID:41225545 | DOI:10.1186/s12891-025-09280-w

J Orthop Surg Res. 2025 Nov 12;20(1):992. doi: 10.1186/s13018-025-06428-1.

ABSTRACT

BACKGROUND: Osteochondral lesions of the talus (OLTs) are common ankle injuries that can cause chronic pain and reduced function when conservative treatment fails. For larger lesions, autologous osteochondral transplantation (AOT) restores the joint surface with hyaline cartilage while offering reliable outcomes. While factors such as lesion size and age affect outcomes, the impact of cigarette smoking remains unclear. This study aimed to assess whether smoking adversely affects long-term outcomes after AOT for OLTs.

METHODS: This retrospective cohort study included 78 patients who underwent AOT between 2015 and 2019, with a minimum follow-up of five years (mean: 100.4 ± 14.7 months). Patients were categorized as smokers (n = 30) or non-smokers (n = 48). Clinical status was assessed using the visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Score (AOFAS), Tegner Activity Scale (pre- and post-op), and Foot and Ankle Outcome Score (FAOS). Statistical tests included the Mann-Whitney U test, Wilcoxon signed-rank test, chi-square test, and Spearman’s correlation analysis, with the significance level set at p < 0.05.

RESULTS: Both groups demonstrated significant improvement in VAS, AOFAS, and Tegner scores postoperatively (p < 0.001). Non-smokers had significantly better outcomes in VAS (p = 0.011), AOFAS (p = 0.008), and FAOS (p = 0.018). Postoperative Tegner scores did not differ significantly (p = 0.498). Baseline characteristics, lesion size, and complication rates were similar between groups. A moderate negative correlation was detected between pack-years and both FAOS (r = – 0.475, p = 0.008) and AOFAS (r = – 0.470, p = 0.009) scores.

CONCLUSIONS: Autologous osteochondral transplantation leads to statistically significant improvements in pain and functional scores in both smokers and non-smokers. However, smoking is associated with higher residual pain and poorer functional outcomes at midterm follow-up, despite no significant differences in activity levels based on Tegner scores. Preoperative smoking cessation should be encouraged in patients undergoing cartilage repair.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.

PMID:41225542 | DOI:10.1186/s13018-025-06428-1

BMC Pediatr. 2025 Nov 12;25(1):927. doi: 10.1186/s12887-025-06115-4.

ABSTRACT

BACKGROUND: Childhood asthma is a prevalent chronic respiratory disease. While inhaled corticosteroids and β-agonists remain cornerstone treatments, growing evidence highlights the complementary role of non-pharmacological interventions in improving asthma outcomes. This study aimed to systematically evaluate the efficacy of diverse non-pharmacological approaches through a network meta-analysis (NMA).

METHODS: Seven English and Chinese databases were searched from their inception to April 1, 2025, for randomized controlled trials (RCTs) related to non-pharmacological intervention in childhood asthma. The risk of bias was assessed using the Cochrane risk of bias tool (ROB). Network meta-analysis was conducted using R 4.2.0 and Stata 14.0 software.

RESULTS: A total of 41 studies with 3164 participants were included. Involved structured exercise programs, controlled breathing techniques, traditional moxibustion therapy, psychological interventions, and traditional therapeutic massage adjuvant treatment measures. Five asthma outcome indicators were focused on: FEV1, FVC, PEF, PAQLQ, and FeNO. The ROB was low in the included studies. The NMA of two-by-two comparisons showed that all non-pharmacological adjunctive interventions were able to improve asthma symptoms better, with exercise training improving FEV1 (MD = 3.67, 95%CI [1.39, 5.95]), PEF (MD = 6.07, 95%CI [1.07, 11.07]), and PAQLQ (MD = 0.93, 95%CI [0.33, 1.52]) with statistical significance (p < 0.05).

CONCLUSION: Five non-pharmacological interventions for childhood asthma demonstrated consistent efficacy across all modalities in alleviating asthma symptoms. Psychological interventions emerged as the optimal adjunctive therapy for improving FEV1, while exercise training exhibited the most potent therapeutic effect on FVC. Furthermore, massage therapy demonstrated superior efficacy in enhancing PEF, PAQLQ scores, and FeNO levels.

PMID:41225527 | DOI:10.1186/s12887-025-06115-4

Syst Rev. 2025 Nov 12;14(1):222. doi: 10.1186/s13643-025-02979-w.

ABSTRACT

BACKGROUND: Sepsis remains a major global health issue, especially in low- and middle-income countries (LMICs) with limited diagnostic resources. This meta-analysis evaluates platelet index ratios (mean platelet volume-to-platelet count, MPV/PLT; platelet distribution width-to-platelet count, PDW/PLT; and platelet distribution width-to-plateletcrit, PDW/PCT) as cost-effective biomarkers for sepsis diagnosis and prognosis in resource-constrained settings.

METHODS: A systematic search was conducted for studies evaluating platelet parameter ratios in sepsis. Inclusion criteria comprised the following: (1) cohort/case-control designs; (2) non-duplicated datasets; (3) available quantitative data for meta-analysis. Exclusion criteria included reviews, abstracts, letters to the editor, and studies with incomplete data. Synthesis methods employed random-effects models to calculate standardized mean differences (SMD) and diagnostic metrics (sensitivity, specificity, etc.), with heterogeneity assessed via I-squared statistics. Publication bias was evaluated through funnel plots and Egger’s test.

RESULTS: Fourteen studies were included. The results revealed that MPV/PLT ratios were significantly higher in neonatal (SMD = 1.48, P = 0.004) and adult sepsis patients (SMD = 0.35, P < 0.001) than in controls. Survivors had significantly lower MPV/PLT ratios than non-survivors in both children/neonate (SMD = 0.67, P < 0.01) and adult group (SMD = 0.41, P < 0.01), with similar trends observed in longitudinal assessments. PDW/PLT was also lower in pediatric survivors (P = 0.009), while no significant differences were found for MPV/PCT in neonates or PDW/PLT in adults. For diagnosing sepsis, MPV/PLT had a sensitivity of 0.55 and specificity of 0.71 in adults, and 0.58 and 0.87 in neonates. For predicting mortality, neonatal sepsis showed higher sensitivity (89%) and specificity (73%) than adult sepsis (63%, 58%). In LMICs, MPV/PLT was elevated at admission in both age groups but was linked to survival only in neonates.

CONCLUSION: The MPV/PLT ratio shows promise as a cost-effective biomarker for sepsis diagnosis and prognosis, particularly in neonatal patients, with important potential applications in LMICs.

SYSTEMATIC REVIEW REGISTRATION: This study has been registered on the international platform of registered systematic review and meta-analysis protocols (INPLASY) (Registration Number: INPLASY202540096). https://doi.org/10.37766/inplasy2025.4.0096 .

PMID:41225524 | DOI:10.1186/s13643-025-02979-w

Virol J. 2025 Nov 12;22(1):373. doi: 10.1186/s12985-025-02999-x.

ABSTRACT

PURPOSE: Present study aimed to compare the boiling and magnetic bead nucleic acid extraction method for HPV genotypes detection.

METHODS: By mixing hemoglobin with HPV positive quality control products, the anti-interference ability of two nucleic acid extraction methods on hemoglobin was simulated. Subsequently, on the basis of paired small sample and longitudinal large sample comparisons, the HPV detection rates between the boiling and magnetic bead-based method were evaluated. Finally, the cost-benefit comparisons of the two extraction methods were further evaluated. A two-sided P value of less than 0.05 was considered statistically significant.

RESULTS: As for boiling method, when the hemoglobin concentration exceeded 30 g/L, HPV positive control could not be detected, nevertheless, the HPV positive control can still be detected even when the hemoglobin concentration reached 60 g/L for magnetic bead method. In the paired small-scale (639 cases) experiment, results indicated that the positive detection rate of HPV using the magnetic bead method was significantly higher than that of the boiling method, with positive rates of 20.66% and 10.02% (P < 0.001), respectively. Additionally, in the longitudinal large-scale analysis (16540 cases) reached the same conclusion. Compared with boiling method, the cost of magnetic bead method increased by 13.14%, however, the detection rate of HPV increased by 106.19%.

CONCLUSION: Compared to the boiling method, the magnetic bead-based nucleic acid extraction technique exhibited superior anti-interference capabilities and a significant higher detection rate for HPV. Furthermore, it is highly cost-effective. It is anticipated that the magnetic bead method will be fully adopted for HPV detection in place of the boiling method in the future. Of course, more research is needed to verify this conclusion.

PMID:41225522 | DOI:10.1186/s12985-025-02999-x

BMC Endocr Disord. 2025 Nov 13;25(1):262. doi: 10.1186/s12902-025-02081-1.

ABSTRACT

BACKGROUND: The estimated glucose disposal rate (eGDR), a novel composite indicator for assessing insulin resistance (IR), remains underexplored for its ability to predict the risk of chronic kidney disease (CKD) in individuals with diabetes or prediabetes.

METHOD: A total of 17,595 patients with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were included. CKD is defined based on the estimated glomerular filtration rate and the urine albumin-to-creatinine ratio. The calculation of eGDR is based on the waist circumference, hypertension status and glycated hemoglobin. Multivariable logistic regression was used to evaluate the association between eGDR and CKD. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Subgroup analysis explores the differences in effects among different populations. Mediating analysis was used to quantify the role of serum uric acid (SUA) in the eGDR-CKD association. Receiver operating characteristic curve (ROC) curves were used to compare the predictive performance of eGDR with that of other IR indices.

RESULTS: After full adjustment, the eGDR showed a significant inverse association with CKD risk. The RCS curves confirmed a linear negative relationship between eGDR and CKD. Subgroup analysis revealed stronger associations in men. Mediation analysis indicated that SUA partially mediated the eGDR-CKD association, accounting for 6.2% of the total effect. ROC analysis revealed that the eGDR shad a moderate predictive ability for CKD in patients with diabetes or prediabetes.

CONCLUSION: This cross-sectional study confirmed that the eGDR is linearly negatively correlated with CKD in a population with diabetes or prediabetes and that its discriminative power is moderate but superior to that of traditional IR indicators. The statistical overlap of SUA on the total association was approximately 6.2%, but the mediating effect was fragile. This finding should be verified in prospective cohorts in the future.

PMID:41225507 | DOI:10.1186/s12902-025-02081-1