Category: Nevin Manimala

J Am Geriatr Soc. 2025 Dec 28. doi: 10.1111/jgs.70266. Online ahead of print.

ABSTRACT

OBJECTIVES: Frailty is a common condition in community-dwelling older adults with high health and socioeconomic implications. However, primary care-led randomized trials have been scarcely tested.

DESIGN: Multicenter cluster randomized clinical trial.

SETTING AND PARTICIPANTS: Two hundred and seventy-three community-dwelling older adults recruited from 12 Spanish primary care centers.

INCLUSION CRITERIA: independence in basic activities of daily living and either prefrailty/frailty using the frailty phenotype or gait speed < 0.8 m/s.

METHODS: Participants were randomized 1:1 by clusters to the intervention or the control group, each cluster being a different primary care center.

INTERVENTION: Physical exercise program, nutritional recommendations, and frailty training to primary care professionals. Interventions were conducted based on the guidelines of the “Consensus document on the prevention of frailty in older adults,” updated in 2022, from the Spanish Health Ministry.

CONTROL: Usual care.

MAIN OUTCOME: Improvement in one category of the frailty phenotype or one point in the Short Physical Performance Battery (SPPB) at 12 and 32 weeks. under Intention-to-treat analysis was conducted.

RESULTS: Mean age 78.1 years, 68.4% female. 25.7% were frail and 74.3% prefrail or with a gait speed lower than 0.8 m/s. The percentage of participants improving the main outcome at week 12 for the intervention and control groups were 70.4% and 49.5%, respectively, absolute risk reduction (ARR) 20.9% (95% confidence interval [CI] 7.3%-34.5%; p < 0.01; n = 191), number needed to treat (NNT) 4.8 (95% CI 2.9-13.6). At 32 weeks of follow-up 81.7% and 51.9% of the intervention and control group improved, respectively, ARR 29.8% (95% CI 13.8%-45.7%; p < 0.001; n = 134), NNT 3.4 (95% CI 2.2-7.2).

CONCLUSIONS AND IMPLICATIONS: A primary care-led intervention consisting of a physical exercise program, nutritional recommendations, and training in frailty was feasible and effective for improving frailty status or physical function in community-dwelling older adults with prefrailty or frailty.

TRIAL REGISTRATION: clinicaltrial.gov: NCT05002439 (18/JUN/2021).

PMID:41456342 | DOI:10.1111/jgs.70266

Soc Work Public Health. 2025 Dec 28:1-12. doi: 10.1080/19371918.2025.2607686. Online ahead of print.

ABSTRACT

This study aimed to examine the impact of Africentric ethnic identity on the relationship between gender and poor neighborhood air quality. Quantitative data were collected from a convenience sample of 122 African American charter school students residing in a northeastern metropolitan area of the United States. Female students reported greater satisfaction with neighborhood air quality and higher Africentric ethnic identity in comparison to male students. Hierarchical regression analysis showed Africentric ethnic identity to operate as a covariate in the relationship between gender and neighborhood air quality. The results showed that Africentric ethnic identity statistically significantly improved the model fit, explaining additional variance in neighborhood air quality beyond gender. Higher Africentric ethnic identity was a function of greater satisfaction with neighborhood air quality in students. Africentric ethnic identity operates as a source of resilience that can help youth combat climate change problems like poor air quality through emotional and mental flexibility.

PMID:41456333 | DOI:10.1080/19371918.2025.2607686

J Appl Clin Med Phys. 2026 Jan;27(1):e70439. doi: 10.1002/acm2.70439.

ABSTRACT

PURPOSE: Achieving a pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) is strongly associated with improved survival. This study investigates whether bilateral asymmetry of quantitative perfusion parameters in normal parenchyma from ultrafast dynamic contrast-enhanced MRI (DCE-MRI), measured using k-means clustering (KMC) before NAC, can predict pCR in breast cancer patients.

MATERIALS AND METHODS: Fifty-six breast cancer patients undergoing NAC with pretreatment ultrafast DCE-MRI (3-9 s/image at 3T) were enrolled. KMC was used to classify tumor and normal parenchymal voxels into five clusters based on maximum enhancement rate (A·α). Ipsilateral-to-contralateral (I/C) ratios of background parenchymal enhancement kinetics (kBPE) and tumor kinetics (kT) were compared between pCR and nonpCR groups. Logistic regression models were developed to predict pCR. Statistical tests included bootstrapping, z-test, chi-square, and Wilcoxon rank-sum.

RESULTS: Patients with residual disease showed significantly higher kBPE in the normal-appearing parenchyma of the ipsilateral breast compared to the contralateral side. Parameters including enhancement rate α, A·α, area under the enhancement curve for 30 s AUC30, volume transfer constant K^{tran s}, and rate constant of contrast transfer, K_ep, were significantly higher, while extravascular extracellular space fractional volume, v_e, was significantly lower in the ipsilateral breast parenchyma versus contralateral breast parenchyma for women who have residual disease (p < 0.05). A prediction model using kBPE asymmetry alone achieved an area under the curve (AUC) of 0.83. Including tumor kinetics improved the AUC to 0.85.

CONCLUSIONS: Bilateral asymmetry of kBPE parameters derived from ultrafast DCE-MRI using KMC before NAC initiation can predict pCR with high accuracy, providing a new minimal-invasive biomarker for treatment response.

PMID:41456332 | DOI:10.1002/acm2.70439

Physiother Res Int. 2026 Jan;31(1):e70156. doi: 10.1002/pri.70156.

ABSTRACT

BACKGROUND AND PURPOSE: Balance impairments are among the most common motor impairments in patients with neurological disorders. Transcranial direct current stimulation (tDCS) and robotic-assisted gait training (RAGT) have recently been used in stroke rehabilitation. This review aims to investigate the effects of combined tDCS and RAGT on balance ability in patients with stroke.

METHODS: Multiple databases, including PubMed, SCOPUS, Embase, Cochrane Library, REHABDATA, and Web of Science, were searched from inception to June 2025. The risk of bias across the included studies was assessed using the “Physiotherapy Evidence Database (PEDro)” scale. Statistical analysis was carried out using “Comprehensive Meta-Analysis Version 4 software”.

RESULTS: Five studies met the eligibility criteria. In total, 207 patients with stroke (mean age 60.73 years, 43% female) were included in this review. The median score on the PEDro scale is 9 with 95% range: 6-10 and IQR: 2. Based on three studies, the meta-analysis on combining tDCS with RAGT for balance in post-stroke patients showed a small, non-significant effect (Berg Balance Scale; SMD = 0.329, 95% CI: -0.622 to 1.279, p = 0.498). Heterogeneity was moderate (I² = 63%, Q = 5.347, p = 0.069) with a prediction interval of -1.233 to 1.892. IMPLICATIONS OF PHYSIOTHERAPY PRACTICE: tDCS combined with RAGT appears safe and well-tolerated, but its effectiveness on balance post-stroke remains inconclusive. The meta-analysis showed a small, non-significant effect with substantial heterogeneity. Although some studies reported significant improvements, variability across protocols and outcomes limits firm conclusions. Further high-quality research is needed to clarify the benefits.

PMID:41456318 | DOI:10.1002/pri.70156

Int J Psychol. 2026 Feb;61(1):e70151. doi: 10.1002/ijop.70151.

ABSTRACT

Although workplace incivility (WI) has been extensively studied, limited attention has been paid to its validation in culturally diverse contexts such as China and Pakistan. Addressing this gap, the present study examines the psychometric properties of the instigated WI scale within these two distinct cultural settings. Furthermore, it investigates the cross-cultural measurement equivalence of the scale using a daily diary methodology. Participants were full-time employees from service-sector organisations in China (n = 110) and Pakistan (n = 118), recruited through snowball sampling. Over 10 days, 758 daily observations were collected from Chinese employees and 836 from Pakistani employees. The findings provide evidence supporting the validity and reliability of the scale in both samples, affirming the conceptual transferability of WI across these cultural contexts. The study also highlights the importance of accounting for cultural nuances in the manifestation and assessment of incivility. Establishing the scale’s validity and equivalence contributes critical methodological groundwork for future cross-cultural research on workplace mistreatment.

PMID:41456315 | DOI:10.1002/ijop.70151

Vestn Otorinolaringol. 2025;90(6):66-71. doi: 10.17116/otorino20259006166.

ABSTRACT

Currently, there are individual studies of the width of the piriform aperture (PA) in different populations, but these data are not tied to standards and do not take into account the age characteristics of the individual.

OBJECTIVE: To measure the width of the PA in the population in different age groups.

MATERIAL AND METHODS: The study involved 577 adults (≥18 years old) of the Central European type of the Caucasian race, divided into groups by gender (273 men and 304 women) and age (18-44, 45-59, 60-74 and over 75 years old), for whom the width of the PA was determined.

RESULTS: The value of the PA (in mm) width in men statistically significantly (p<0.05) exceeds the female values when comparing both all subjects (24.13±0.20 in men and 22.67±0.19 in women) and separately among all age groups: 18-44 (23.46±0.34 and 22.05±0.43), 45-59 (24.13±0.42 and 22.56±0.34), 60-74 (24.15±0.41 and 22.64±0.31) and over 75 years old (24.87±0.40 and 23.43±0.40).

CONCLUSIONS: The results can be used as standards for the width of the piriform aperture of the Central European type of the Caucasian race.

PMID:41456292 | DOI:10.17116/otorino20259006166

Vestn Otorinolaringol. 2025;90(6):55-59. doi: 10.17116/otorino20259006155.

ABSTRACT

Vasomotor rhinitis (VR) is a chronic disease of the nasal mucosa that occurs due to impaired neurovegetative and endocrine regulation of vascular tone. The pathogenesis of vasomotor rhinitis is not fully understood; it is believed to be caused by dysregulation of the sympathetic and parasympathetic nervous systems, leading to inflammation of the nasal mucosa.

OBJECTIVE: To examine the role of proinflammatory (TNF-α, IL-1, IL-8) and anti-inflammatory (IL-4 and IL-10) cytokines in chronic vasomotor rhinitis.

MATERIAL AND METHODS: A total of 88 participants were examined: patients with chronic VR (VR group, n=42) and apparently healthy blood and nasal secretion donors (control group, n=46). Venous blood and nasal secretions were used for the study. The levels of TNF-α, IL-1, IL-4, IL-8, and IL-10 in the blood and nasal secretions were determined by enzyme-linked immunosorbent assay on a Multiskan FC immunoassay analyzer (Thermo Fisher Scientific Instruments Co., Ltd., USA). Statistical analysis of the study results was performed using the Statistica 10.0 software package. The sample was described using the median and interquartile range (25th and 75th percentiles). Normality of distribution was tested using the Kolmogorov-Smirnov method, with a significance level of p<0.05.

RESULTS: The median IL-1 level (1.65 pg/ml) in serum in VR patients was 5.7 times lower than the median in the control group, while the median IL-8 level (0.94 pg/ml) was 10.1 times lower. No statistically significant differences were found between the VR and control groups for TNF-α, IL-4, and IL-10 levels. The median IL-1 level (19.6 pg/ml) in VR patients was 22.8 times higher than in the control group. In nasal washes, the median IL-8 level was 24.5 times higher than the median in the control group, reaching 38.7 pg/ml. The median TNF-α, IL-4, and IL-10 levels in the VR group did not differ statistically significantly from the medians of these cytokines in the control group.

CONCLUSION: The study revealed low levels of IL-1 and IL-8 in the blood and high levels in nasal secretions in patients with vasomotor rhinitis. No statistically significant differences were found in the levels of the anti-inflammatory cytokines IL-4 and IL-10. The contrasting changes in the levels of proinflammatory cytokines IL-1 and IL-8 in vasomotor rhinitis may indicate a lack of a leading role for cytokines in the pathogenesis of this condition.

PMID:41456290 | DOI:10.17116/otorino20259006155

Vestn Otorinolaringol. 2025;90(6):34-40. doi: 10.17116/otorino20259006134.

ABSTRACT

OBJECTIVE: To optimize diagnostics of acubarotrauma by identifying its objective signs based on the results of acoustic reflexometry.

MATERIAL AND METHODS: A prospective study was conducted at the forefront of medical evacuation in a combat zone, including examination of patients with unilateral acubarotrauma. During the study, instrumental diagnostics were performed: digital otoscopy, tone threshold audiometry, low-frequency acoustic impedancemetry with the study of ipsilateral acoustic reflexes.

RESULTS: The results of the study revealed a statistically significant relationship with a moderate correlation of the absence of registration of acoustic reflexes with time on the side of the acubarotrauma – the first three days from the moment of injury, as well as on the opposite side – the first day from the moment of injury.

CONCLUSION: Acoustic reflexometry is recommended in cases of unilateral traumatic damage to the organ of hearing to confirm the mine-explosive etiology.

PMID:41456287 | DOI:10.17116/otorino20259006134

Vestn Otorinolaringol. 2025;90(6):6-13. doi: 10.17116/otorino2025900616.

ABSTRACT

Data on the epidemiology of ear and mastoid diseases, including chronic suppurative otitis media (CSOM), In Russia are fragmented and presented in various non-specialized journals. However, analysis of incidence and prevalence dynamics allows us to assess the development of this pathology in the population, the accessibility of medical care, the effectiveness of treatment measures, and identify ways to improve these indicators.

OBJECTIVE: To analyze the epidemiology and treatment of ear and mastoid diseases, including chronic suppurative otitis media, in the Russian Federation and Moscow.

MATERIAL AND METHODS: A retrospective quantitative assessment of the prevalence (overall) and incidence (primary) of ear and mastoid diseases, including chronic suppurative otitis media, was conducted using data from state statistics services and reports from Moscow otolaryngology hospitals for the period from 2010 to 2024.

RESULTS: According to statistical reports, in recent years there has been a decrease in the incidence of ear and mastoid diseases in the overall morbidity structure in the Russian Federation from 2.4% to 1.8%. In 2022, the overall incidence was 28.75 cases per 1000 population, primary – 17.6 cases per 1000 population. The average overall and primary incidence of ear and mastoid diseases in Moscow from 2013 to 2023 was 32.9 cases per 1000 population, and primary – 23.2 cases per 1000 population. In the Russian Federation and Moscow over the past 10 years, there has been a tendency towards a decrease in the primary and overall incidence of chronic otitis media (In Russia, the average primary incidence is 0.4, the overall – 2.09, in Moscow – 0.17 and 1.39, respectively). In Moscow, there has been an increase in the proportion of patients with CSOM in hospitals (from 6.2% to 8.1%) and in the structure of ear and otitis media diseases (from 21.7% to 39.2%). A sharp increase in surgical activity was noted for ear and otitis media diseases (from 24.3% to 69.9%), as well as for CSOM (from 50.6% to 87.8%), with CSOM largely due to tympanoplasty (from 66.7% to 85.8%). The increase in surgical activity in the management of patients with CSOM has led to a decrease in the proportion of sanitary operations for urgent or emergency indications (from 10.7% to 2.3%). In a specialized department (using the Ear Microsurgery Research Department of the L.I. Sverzhevsky Research Institute of Oncology and Orthopedics of the Moscow Health Department as an example), which provides elective surgical care to patients with chronic otitis media, a significant (threefold) increase in the number of patients treated and the number of reconstructive and sanitizing surgeries performed was observed from 2010 to 2024, driven by the intensification of the treatment process. Meanwhile, the overall proportion of patients with this pathology in the department’s patient population has remained virtually unchanged over the past 15 years (60% on average), as has the percentage of surgical procedures performed.

CONCLUSION: Optimization of healthcare has resulted in a reduction in the incidence of ear and mastoid diseases and chronic suppurative otitis media, as well as an increase in the volume of care provided to patients with chronic suppurative otitis media due to increased hospital capacity and physician workload.

PMID:41456282 | DOI:10.17116/otorino2025900616

Cell Mol Biol (Noisy-le-grand). 2025 Dec 28;71(12):94-100. doi: 10.14715/cmb/2025.71.12.11.

ABSTRACT

Accurate diagnosis of breast lesions is often complicated by the morphological overlap between benign, pre-malignant, and malignant entities on hematoxylin and eosin (H&E) stained sections. This study evaluated the diagnostic utility of an immunohistochemical (IHC) panel, comprising Estrogen Receptor (ER), Cytokeratin 5/6 (CK5/6), and Leukocyte Common Antigen (CD45), in resolving these diagnostic ambiguities among Iraqi patients. The panel was designed to differentiate epithelial (ER, CK5/6) and lymphoid (CD45) lineages, enabling the distinction between benign, pre-malignant, and malignant processes. A retrospective cross-sectional analysis was performed on 120 challenging breast lesions where the initial H&E diagnosis was inconclusive. Statistical performance was assessed using sensitivity, specificity, and accuracy metrics, with significance determined at p < 0.05. The IHC panel resulted in the reclassification of 53 cases (44.2%), with the highest reclassification in ADH (72.0%). The combined panel demonstrated 91.1% sensitivity, 93.3% specificity, and 92.5% accuracy (p < 0.001) for differentiating benign from malignant lesions. ER and CK5/6 were decisive in the majority of reclassified cases. In conclusion, the three-marker IHC panel (ER, CK5/6, and CD45) provides a statistically significant improvement in diagnostic accuracy and reliability in challenging breast lesions, reducing diagnostic uncertainty and supporting optimal patient management.

PMID:41456259 | DOI:10.14715/cmb/2025.71.12.11