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Nevin Manimala Statistics

Epidemiology of Injury in Elite and Amateur Soccer Referees: A Systematic Review and Meta-analysis

Sports Med. 2025 Sep 29. doi: 10.1007/s40279-025-02326-y. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology of injury in soccer has traditionally focused on soccer players, rather than match officials. Although injury data on referees exist, no comprehensive review has summarized injury profiles in this population.

OBJECTIVE: To conduct a systematic review and meta-analysis of injury epidemiology in elite and amateur soccer referees, focusing on injury rates, types, locations, severity, and causes.

METHODS: PubMed (Medline), Web of Science, Scopus, CINAHL, and SPORTDiscus, covering their entire history up to 19 April 2025 were searched. This review included prospective and retrospective studies reporting injury incidence or prevalence among football match officials, with a study period of at least one season. Studies needed to specify injury definitions and include data on injury location, type, mechanism, or severity. Both male and female officials were eligible. Systematic reviews, commentaries, and letters were excluded. Study quality and risk of bias were evaluated using the STROBE-SIIS, in addition to the Newcastle-Ottawa Scale and funnel plots. Injury incidence rates were estimated using a random effects Poisson regression, accounting for heterogeneity and moderators. Heterogeneity was assessed with the I2 statistic.

RESULTS: A total of 17 studies were included, encompassing 3621 referees. The most frequent injuries were strains and sprains in the knee and ankle. The overall injury incidence was 2.19 injuries per 1000 h of exposure (95% CI 1.30-3.69). On-field referees experienced an incidence rate of 1.46 injuries per 1000 h of exposure (95% CI 0.76-2.81), while assistant referees had a lower rate of 0.84 per 1 h of exposure (95% CI 0.36-1.97). During matches, the injury incidence was 2.24 per 1000 h of exposure (95% CI 1.38-3.64), compared with 0.67 injuries per 1000 h of exposure during training sessions (95% CI 0.36-1.24). However, despite sensitivity analysis, there were still high levels of heterogeneity across included studies.

CONCLUSIONS: Findings noted higher injury incidence during matches compared with training, and on-field referees compared with assistants. The variation in injury profiles highlights the importance of implementing targeted preventive strategies tailored to the unique demands of refereeing. However, there is still a lack of research in this population, especially in female referees.

PROSPERO REGISTRATION NUMBER: CRD42024497970.

PMID:41021207 | DOI:10.1007/s40279-025-02326-y

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Nevin Manimala Statistics

The causal relationship between platelet indices and liver cancer: a bidirectional two-sample Mendelian randomization study

Discov Oncol. 2025 Sep 29;16(1):1752. doi: 10.1007/s12672-025-03536-6.

ABSTRACT

BACKGROUND: Platelet indices are non-invasive biomarkers used to assess disease status. Observational studies have shown that platelet indices are related to liver cancer. However, the specific relationship between the two is still inconclusive. We conducted a Mendelian randomization (MR) study to investigate the causal relationship between platelet indices and liver cancer.

METHODS: We identified 2 cancer outcomes (liver cell carcinoma, malignant neoplasm of liver and intrahepatic bile ducts) from genome-wide association studies (GWAS). We used inverse variance weighted (IVW) method as the main method. In order to evaluate the potential horizontal pleiotropy or heterogeneity, sensitivity analyses were examined via MR-Egger regression, heterogeneity test, pleiotropy test.

RESULTS: Two-Sample MR analysis showed there were causal relationships between platelet indices and liver cancer. The mean platelet volume was positively associated with hepatocellular carcinoma (HCC) risk, while platelet count was inversely correlated with HCC risk, platelet endothelial cell adhesion molecule levels were significantly related to an increased malignant neoplasm of liver and intrahepatic bile ducts risk. In addition, we conducted reverse MR analyses and found that malignant neoplasm of liver and intrahepatic bile ducts was positively associated with platelet count and platelet crit, but negatively correlated with platelet distribution width. Following multivariable mendelian randomization adjustments for potential confounding variables, the independent effects of platelet indices on HCC were not statistically significant.

CONCLUSIONS: The bidirectional causal relationship between platelet indices and liver cancer may be mediated by confounding factors such as liver cirrhosis. Further validation through mediation MR analyses or larger-scale replication studies is required to elucidate these causal pathways.

PMID:41021163 | DOI:10.1007/s12672-025-03536-6

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Nevin Manimala Statistics

Mendelian randomization analysis of druggable gene expression in liver cancer risk and autoimmune hepatitis

Discov Oncol. 2025 Sep 29;16(1):1774. doi: 10.1007/s12672-025-03579-9.

ABSTRACT

BACKGROUND: Liver cancer remains one of the most prevalent and lethal malignancies worldwide, while autoimmune hepatitis is an immune-mediated inflammatory liver disease characterized by circulating autoantibodies and distinctive histopathological features. Mendelian Randomization (MR), as an innovative epidemiological research method, providing a reliable approach for exploring causal relationships between gene expression and liver disease risk.

METHODS: This study employed a comprehensive two-sample Mendelian randomization analytical approach to systematically evaluate the causal relationships between druggable gene expression levels and liver disease risk, including both liver cancer and autoimmune hepatitis. The study incorporated expression quantitative trait loci (eQTL) data from 4,479 druggable genes as exposure variables, with liver cancer genome-wide association study (GWAS) data and autoimmune hepatitis GWAS data serving as outcome variables.

RESULTS: Mendelian randomization analysis revealed significantly different impacts of multiple gene expression levels on liver disease outcomes. For liver cancer, high expression of CCL7 and CCL11 genes demonstrated protective effects, with CCL11 gene showing statistical significance (HR = 0.600, 95%CI: 0.409-0.953, p = 0.027), suggesting these genes may exert protective functions through immune response regulation mechanisms. Conversely, high expression of CASP8, CD5, and FGF21 genes significantly increased patient mortality risk.

CONCLUSIONS: This study provides sufficient and reliable scientific evidence for liver disease risk-related genes through multidimensional Mendelian randomization validation analysis.

PMID:41021153 | DOI:10.1007/s12672-025-03579-9

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Nevin Manimala Statistics

Transitioning to da Vinci Xi for colorectal cancer surgery: a prospective cohort study of 102 cases from a UK centre with a structured robotic programme

J Robot Surg. 2025 Sep 29;19(1):644. doi: 10.1007/s11701-025-02832-1.

ABSTRACT

This study evaluated short-term outcomes and learning curves following the introduction of the Intuitive© da Vinci Xi robotic platform for elective colorectal cancer resections at West Hertfordshire Teaching Hospital NHS Trust (WHTH). A smooth transition was enabled by prior experience with the CMR Surgical© Versius platform, with outcomes benchmarked against national data. A prospective cohort study included consecutive patients undergoing elective colorectal resections between April 2024 and March 2025. Data included demographics, diagnosis, operative details, complications, length of stay (LOS), and oncological outcomes. Results were compared with historical laparoscopic data from the National Bowel Cancer Audit (NBOCA, 2019-2022) and Model Health System (MHS, 2024). Learning curves for operative time were assessed using cumulative sum (CUSUM) analysis across three procedures: right hemicolectomy (RH), anterior resection (AR), and abdominoperineal resection (APR).A total of 102 patients were included, with a median age of 69 years (IQR = 60-75), and 54.9% (n = 56) were male. All colonic resections (n = 72) achieved a lymph node yield ≥ 12, significantly higher than the 88.1% in NBOCA (p = 0.001). Among rectal resections (n = 30), 96.7% had negative margins versus 90.1% in NBOCA (p = 0.10). Conversion to open surgery was 3% (n = 3), the anastomotic leak rate was 1% (n = 1), and 4% (n = 4) required a return to theatre. MHS data showed that 13% of all colorectal patients at WHTH had a LOS ≥ 9 days, compared to 29% nationally (p = 0.0001), decreasing to 7.1% in the robotic cohort. CUSUM analysis showed stabilisation after ~ 12 right hemicolectomies and 20 low pelvic resections, with variability among surgeons. Surgeons with prior robotic experience achieved faster proficiency and generated time savings. The successful introduction of the da Vinci Xi platform at WHTH, supported by prior Versius experience, led to excellent oncological outcomes, shorter hospital stays, and low complication rates. These findings highlight the value of structured robotic implementation in advancing colorectal cancer care within the NHS.

PMID:41021138 | DOI:10.1007/s11701-025-02832-1

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Nevin Manimala Statistics

Comprehensive analysis of Mithi river water quality: pollution assessment, and lead bioremediation by indigenous bacteria

World J Microbiol Biotechnol. 2025 Sep 29;41(10):350. doi: 10.1007/s11274-025-04589-z.

ABSTRACT

Environmental pollution is a biggest challenge faced by whole world at current time. The natural resources are victims of pollution and contamination of natural resources with heavy metals such as Pb. Pb is a highly toxic and frequent pollutant all around the world. In present study, Mithi River, a highly polluted urban water body was physico-chemically analyzed at four different sites along its course and their association was statistically analysed. Further, Pb bioremediating bacteria were isolated from Mithi river water and analysed for their Pb remediation potential. The findings revealed consistently low water quality across all sites, indicating high pollution levels, particularly in the lower stretch of river. Mithi River exhibited a substantial total heterotrophic bacteria (THB) (Taximan- 2.89 × 109 and BKC- 2.13 × 109) and a prevalence of lead-resistant bacteria (Taximan- 3.16 × 108 and BKC 2.24 × 107). A total 21 Pb resistant bacteria were isolated and gram negative coccobacilli were the most dominant. Notably, P. mirabilis demonstrated ability to bioremediate up to 100% of lead within 48 h. The SEM-EDX analysis illustrated biosorption of Pb on cell surface. Furthermore, P. mirabilis secretes significant amount of extracellular components in Pb concentration dependent manner. The study demonstrated that P. mirabilis exhibits tolerance to a wide range of environmental conditions, including variations in pH, temperature, salinity, and resistance to various toxic pollutants like heavy metals and organic contaminants. This broad tolerance spectrum to environmental conditions, combined with its strong bioremediation potential, highlights P. mirabilis as a promising candidate for lead bioremediation. Though, real-time application of bioremediation process is still lagging behind and needs immediate attention.

PMID:41021137 | DOI:10.1007/s11274-025-04589-z

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Nevin Manimala Statistics

Low pre-treatment neutrophil-to-lymphocyte ratio predicted a better survival in recurrent/metastatic cervical cancer treated with PD-1/PD-L1 inhibitors

Discov Oncol. 2025 Sep 29;16(1):1756. doi: 10.1007/s12672-025-02862-z.

ABSTRACT

BACKGROUND: A precise predictor is urgently needed for immunotherapy in cervical cancer (CC), which would be very helpful for disease monitoring. Thus, we explore the relationship between pre-treatment neutrophil-to-lymphocyte ratio (NLR) and prognosis in recurrent/metastatic CC patients who were treated with PD-1/PD-L1 inhibitors.

METHODS: A total of 282 patients with recurrent/metastatic cervical cancer were enrolled in this retrospective study from December 2018 to September 2023. The area under the receiver operating characteristic (ROC) curve was used to identify the optimal threshold for evaluating the influence of pre-treatment NLR on patients’ survival. Kaplan-Meier analysis was conducted to determine the predictive roles of pre-treatment NLR for progression-free survival of immunotherapy (PFSi) and overall survival (OS).

RESULTS: A pre-treatment NLR = 3.91 was determined to be the optimal cut-off value for predicting patient prognosis, with an AUC of 0.636 (P < 0.05). Patients with a pre-treatment NLR < 3.91 (low-NLR group) exhibited significantly extended PFSi (P < 0.001) and OS (P < 0.001) compared to those with pre-treatment NLR ≥ 3.91 (high-NLR group). Notably, lower pre-treatment NLR was associated with better objective response rate (36.8% vs. 18.3%, P < 0.001). In the stratification analysis, the predictive roles of pre-treatment NLR were mainly found in patients with positive expression of PD-L1 (P = 0.041 for PFSi; P = 0.001 for OS). Moreover, regardless of when the immunotherapy was initiated, a lower pre-treatment NLR correlated with longer survival.

CONCLUSION: The pre-treatment NLR could be a biomarker for predicting the response to anti-PD-1/PD-L1 therapy in recurrent/metastatic CC. In combination with PD-L1 status, it may improve the benefits of immunotherapy and lower the treatment costs.

PMID:41021135 | DOI:10.1007/s12672-025-02862-z

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Nevin Manimala Statistics

Infrared thermal imaging of muzzle surface region and its temperature profile associated with calving process in buffalo (Bubalus bubalis)

Trop Anim Health Prod. 2025 Sep 29;57(8):410. doi: 10.1007/s11250-025-04667-2.

NO ABSTRACT

PMID:41021134 | DOI:10.1007/s11250-025-04667-2

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Nevin Manimala Statistics

Single-port vs multi-port retroperitoneal robotic partial nephrectomy in obese patients: a meta-analysis of perioperative and functional outcomes

J Robot Surg. 2025 Sep 29;19(1):643. doi: 10.1007/s11701-025-02693-8.

ABSTRACT

To compare perioperative and oncologic outcomes between single-port (SP) and multi-port (MP) retroperitoneal robotic-assisted partial nephrectomy (RAPN) in obese patients with renal tumors. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Web of Science up to July 2025. Eligible studies were those directly comparing SP-RAPN with MP-RAPN in obese patients (BMI ≥30 kg/m2). Extracted data included operative duration, intraoperative blood loss, warm ischemia time, length of hospitalization, complication rates, and oncologic outcomes, which were synthesized using RevMan 5.4. Three retrospective studies involving 694 patients (252 SP, 442 MP) were included. SP-RAPN was associated with a shorter hospital stay (WMD = -0.29 days, P = 0.02) but a longer warm ischemia time (WMD = 5.23 min, P < 0.00001). No significant differences were observed in operative time, estimated blood loss, complication rate, or positive surgical margins. The SP group had higher tumor complexity based on R.E.N.A.L. nephrometry scores. SP-RAPN demonstrates comparable safety and oncologic outcomes to MP-RAPN in obese patients, with the added benefit of reduced hospital stay. However, increased ischemia time should be considered when selecting the surgical approach. High-quality prospective trials are needed to confirm these findings.

PMID:41021133 | DOI:10.1007/s11701-025-02693-8

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Nevin Manimala Statistics

Antifungal potential of hydrothermal liquefaction wastewater in plant protection

World J Microbiol Biotechnol. 2025 Sep 29;41(10):349. doi: 10.1007/s11274-025-04573-7.

ABSTRACT

This study investigates the antifungal potential of hydrothermal liquefaction (HTL) wastewater against Verticillium dahliae and its effects on the growth of pepper plants (Capsicum annuum L.). The HTL process generates wastewater containing various antimicrobial compounds, which can offer a sustainable alternative for plant protection. In this research, the biological control agent Trichoderma virens and HTL wastewater were applied both individually and in combination to assess their impact on plant growth and pathogen suppression. The results demonstrated that specific HTL wastewater treatments significantly enhanced root and shoot growth, biomass, and chlorophyll content in pepper plants. Plant growth observed in pathogen-free conditions may be related to the stimulation of plant physiology by biologically active components contained in wastewater, indicating a biostimulatory effect. Notably, the 4th wastewater mixture (wm) exhibited the highest efficacy, promoting plant development and mitigating the negative effects of V. dahliae. The combination of T. virens and wastewater also showed synergistic effects, reducing disease severity by up to 64% and improving plant biomass and structural parameters. Statistical analysis revealed significant differences among treatments, highlighting the potential of HTL wastewater as a natural and sustainable strategy for managing soil-borne pathogens. These findings suggest that integrating HTL wastewater with biocontrol agents could offer a promising approach to sustainable agriculture.

PMID:41021129 | DOI:10.1007/s11274-025-04573-7

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Nevin Manimala Statistics

Efficacy of fluid flow posterior capsule polishing in reducing capsule rupture and enhancing visual recovery during phacoemulsification cataract surgery

Int Ophthalmol. 2025 Sep 29;45(1):397. doi: 10.1007/s10792-025-03748-3.

ABSTRACT

OBJECTIVE: Cataracts remain the leading cause of blindness worldwide, and phacoemulsification cataract surgery is the gold standard for cataract treatment. However, complications such as posterior capsule rupture (PCR) and posterior capsule opacification (PCO) continue to affect success of the procedure. This study investigates effect of fluid flow posterior capsule polishing in reducing the incidence of PCR and PCO during phacoemulsification cataract surgery, with the goal of improving surgical outcomes and postoperative recovery.

METHODS: A total of 290 eyes from cataract patients were randomly assigned to two groups: the fluid flow polishing group (n = 144) and the mechanical polishing group (n = 146). The incidence of posterior capsule rupture and other postoperative outcomes were compared.

RESULTS: The posterior capsule rupture rate in the fluid flow polishing group was 0%, compared to 15.38% in the mechanical polishing group (p < 0.05). The best-corrected visual acuity (BCVA) at 1 day and 1 month post-surgery was significantly higher in the fluid flow group (p < 0.05). Furthermore, the incidence of posterior capsule opacification (PCO) at 1 month was significantly lower in the fluid flow polishing group compared to the mechanical polishing group (p < 0.05). In subgroup analysis, patients older than 60 years exhibited a statistically significant difference in posterior capsule rupture rates (p < 0.05).

CONCLUSION: Fluid flow posterior capsule polishing significantly reduces the incidence of posterior capsule rupture in phacoemulsification cataract surgery, particularly in elderly patients, and contributes to better visual recovery postoperatively. This technique can be considered a safe and effective modification in cataract surgery to improve patient outcomes and reduce complications.

PMID:41021122 | DOI:10.1007/s10792-025-03748-3