Nevin Manimala

Soc Sci Med. 2025 Jan 16:117703. doi: 10.1016/j.socscimed.2025.117703. Online ahead of print.

ABSTRACT

The prevalence of loneliness is higher among older people; however, few studies have examined its longitudinal patterns and associated risk factors, particularly social network resources. Using data from six waves of the English Longitudinal Study of Ageing (2008/09 to 2018/19, N = 4740) and group-based trajectory modelling (GBTM), we identified five groups of loneliness trajectories: three with stable levels (37% “stable low”; 26% “stable medium”; 9% “stable high”) and two with time-varying scores of loneliness (8% “increasing”; 20% “decreasing”). Multinomial regression models and GBTM were used to examine baseline and time-varying factors associated with these trajectories. We created composite measures to capture the presence and key facets of social network resources (including size, support, closeness, and frequency of contact) for four different social relationship domains (partner, children, immediate family, and friends). Our results show that, among those with family or friends, older people with higher social network resources and those who maintained or improved them over time reported lower levels of loneliness. Findings also suggest that all social relationship domains contributed to feelings of loneliness in later life. Also, we find that respondents in poor health and depressed, as well as those whose health deteriorated over time, were more likely to have stable high or increasing levels of loneliness. The study highlights the need to investigate loneliness from a life course perspective, account for the complexity of social relationships in later life beyond their mere presence or absence, and include their quality and quantity as well as multiple domains of family and intergenerational relationships.

PMID:39956740 | DOI:10.1016/j.socscimed.2025.117703

J Surg Educ. 2025 Feb 15:103463. doi: 10.1016/j.jsurg.2025.103463. Online ahead of print.

ABSTRACT

OBJECTIVE: Compare scoring outcomes between interviewers blinded to scores/grades/MSPE and those with the full applicant file to evaluate the effect of blinding on interview scores and ensure applicants can be confidently evaluated when blinding is used.

DESIGN, SETTING AND PARTICIPANTS: Nineteen interviewers were purposively randomized to receive a complete application or file with all information except applicant grades/MSPE/USMLE score(s) of 90 applicants prior to 218 interviews during 2022 to 2023 general surgery recruitment. Blinding was randomly assigned while ensuring blinded and nonblinded interviews for both interviewers and applicants. Two program leaders involved in study implementation were excluded from blinding. All other aspects of the selection process remained unchanged from historic methods. Each applicant had 3 to 4 interviews. Each interview was scored prior to discussion with other faculty using a 10-point scale. Descriptive and univariate statistics analyzed scoring patterns. Qualitative data regarding the experiences of blinded interviewers was analyzed to generate themes.

RESULTS: There were no differences in interview scores or difference from the applicants’ mean scores between blinding groups. This remained true for within-applicant analyses and for all but 1 interviewer (95%) for within-interviewer analyses. Between-interviewer score differences were seen for interview scores across all interviewers and when comparing nonblinded vs. nonblinded scores across interviewers, but not when comparing blinded vs. blinded scores across interviewers. Qualitative data support the ability to confidently evaluate interview performance when blinded, frequent practice of “self-blinding” to limit bias even when given scores/grades/MSPE, and belief that scores/grades/MSPE are relevant for screening, but the interview has separate priorities.

CONCLUSIONS: Blinding of interviewers to scores/grades/MSPE did not significantly change interview scoring outcomes. Interviewer experiences support the ability to confidently evaluate interview performance when blinded. Given that negative effects of blinding were not found and prior work supports that bias may be mitigated by blinded interviews, we support its use in residency recruitment.

PMID:39956727 | DOI:10.1016/j.jsurg.2025.103463

Surgeon. 2025 Feb 15:S1479-666X(25)00008-3. doi: 10.1016/j.surge.2025.01.007. Online ahead of print.

ABSTRACT

OBJECTIVES: Anecdotally, surgical intervention for acute complicated mastoiditis within our centre differed between clinicians. We aimed to assess our outcomes and experience.

METHODS: A retrospective observational study was undertaken of children with mastoiditis without intracranial complications admitted between January 2017-September 2022. Electronic records were utilised for data collection. Mann-Whitney U and Chi-square test were used for statistical analysis. Operative intervention, length of stay (LOS), complications and 30 day readmission were analysed.

RESULTS: There were 101 patients with a median age of 2 years and 50 (55 %) were male. Thirty-nine patients (39 %) underwent surgery. Thirty-two patients had mastoiditis with subperiosteal abscess formation without intracranial collections. Seventeen patients (44 %) underwent cortical mastoidectomy (median LOS 5.5 days). Twenty two patients (56 %) underwent incision and drainage (I + D) of abscess plus myringotomy (median LOS 5 days), p = 0.58. The mastoidectomy group had 2 complications and the I + D group had none.

CONCLUSIONS: For mastoiditis with local subperiosteal abscess and no intracranial component, a cortical mastoidectomy may not always be required.

PMID:39956720 | DOI:10.1016/j.surge.2025.01.007

Vaccine. 2025 Feb 15:126815. doi: 10.1016/j.vaccine.2025.126815. Online ahead of print.

ABSTRACT

BACKGROUND: A novel 13-valent pneumococcal conjugate vaccine (PCV13-TT) has been widely used in China since its licensure in 2019. The prelicensure pivotal clinical study (PCV13-002) showed strong immune responses against 13 serotypes with PCV13-TT using two different 3P + 1 schedules starting at either 2 (PCV13-2M) or 3 months (PCV13-3M) of age.

METHODS: To assess antibody persistence, healthy Chinese toddlers from PCV13-002 were recalled for blood collection at 1 and 2 years post booster dose. Antibody persistence was evaluated using ELISA and OPA assay methods to measure serotype-specific antibodies.

RESULTS: Similar immune responses were noted for both PCV13-3M and PCV13-2M groups. IgG GMCs remained high (ranging from 0.39 to 4.68 μg/mL) through 2 years post 4 doses of PCV13-TT, with IgG positive rates against most serotypes maintained at ≥90%. Both OPA GMTs and OPA positive rates remained high compared to levels observed at 1 month post booster.

CONCLUSION: After complete dosing schedule of PCV13-TT starting from either 2 months or 3 months, the antibody level declined through 1 year and 2 years post booster dose, while still remained at relatively high levels at the two timepoints as compared to those observed at 1 month post booster dose for the majority of serotypes.

CLINICAL TRIAL REGISTRATION: CTR20182353.

PMID:39956719 | DOI:10.1016/j.vaccine.2025.126815

Nord J Psychiatry. 2025 Feb 16:1-10. doi: 10.1080/08039488.2025.2464634. Online ahead of print.

ABSTRACT

PURPOSE: While research and public debate have increasingly focused on the effects of pornography consumption, the experiences of those documented in pornography have been largely overlooked. This study aims to address this gap by examining the vulnerabilities and health risks faced by this population.

MATERIALS AND METHODS: Individuals aged 18 and older documented in pornography in Sweden were recruited to participate in face-to-face interviews. A total of 120 participants completed study-specific questions and standardized questionnaires on their background, experiences in pornography, and health status. Descriptive statistics were reported, and regression analyses were performed to assess factors impacting PTSD symptom severity and dissociative symptoms.

RESULTS: Participants reported high levels of abuse both in childhood and during pornography production. Nearly all participants had experienced sexual abuse (88%), psychological abuse (90%), and physical abuse (79%) as children. In the context of pornography production, they were subjected to further abuse and exploitation, including verbal abuse (87%), rape (65%), physical assault (56%), third-party control (56%), and online harassment (57%). The consequences of this continuous polyvictimization were significant: 84% exhibited clinically significant PTSD symptoms, 60% clinically significant dissociative symptoms, 69% had attempted suicide, and 80% had been diagnosed with at least one mental health problem. Regression analyses revealed that childhood and online polyvictimization significantly predicted PTSD symptom severity, while polyvictimization within pornography production predicted dissociative symptoms.

CONCLUSIONS: Our findings highlight the urgent need for comprehensive mental health interventions and legal reform to protect this vulnerable population and address the unique harms stemming from documentation in pornography.

PMID:39955768 | DOI:10.1080/08039488.2025.2464634

Adv Healthc Mater. 2025 Feb 16:e2404680. doi: 10.1002/adhm.202404680. Online ahead of print.

ABSTRACT

Traditional intracranial pressure (ICP) monitoring methods, using intraventricular catheters, face significant limitations, including high invasiveness, discrete data, calibration complexities, and drift issues, which hinder long-term and stable monitoring. Here, a non-surgical, in-stent membrane bioelectronic system is presented for continuous and reliable ICP monitoring. This platform integrates a capacitive thin-film sensor with a stent, enabling precise real-time detection of pressure fluctuations directly within the dural venous sinus without requiring skull penetration or frequent recalibration. The sensor demonstrates a high sensitivity of 0.052%/mmHg and a broad, readable pressure range of 3-30 mmHg while maintaining calibration-free and drift-free performance. A series of in vivo studies highlight the system’s superior sensitivity, rapid sampling rate, and long-term stability compared to conventional microcatheters. Statistical analyses reveal a strong agreement between the device and clinical reference, underscoring its potential to revolutionize ICP monitoring. These advancements pave the way for broader clinical applications, minimizing complications and improving patient outcomes in neurocritical care.

PMID:39955741 | DOI:10.1002/adhm.202404680

Arch Osteoporos. 2025 Feb 16;20(1):27. doi: 10.1007/s11657-025-01501-y.

ABSTRACT

A surrogate FRAX® model for Mongolia has been constructed using age- and sex-specific hip fracture rates for mainland China and age- and sex-specific mortality rates from Mongolia.

INTRODUCTION: FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the development of a surrogate FRAX model is recommended based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.

OBJECTIVE: This report describes the development and characteristics of a surrogate FRAX model for Mongolia.

METHODS: The FRAX model used the ethnic-specific incidence of hip fracture in mainland China, combined with the death risk for Mongolia in 2015-2019. Intervention thresholds were developed based on fracture probabilities equivalent to women with a prior fragility fracture, and their impact was assessed in a referral cohort comprising men at age 50 and above and postmenopausal women. The number of hip fractures in 2015 and 2050 was estimated based on United Nations’ predicted changes in population demography.

RESULTS: The surrogate model gave similar hip fracture probabilities to estimates from China. Age-dependent intervention thresholds for a major osteoporotic fracture ranged from a 10-year probability of 2.4% at the age of 40 years to 13.7% at the age of 90 years. In the cohort of those eligible for assessment, 46% of men and 36% of women were eligible for treatment because of a prior fracture. Based on intervention thresholds, a further 0.5% of men and 7.0% of women would be eligible for treatment. It was estimated that 440 hip fractures arose in 2015 in individuals aged 50 years and older in Mongolia, with a predicted 4.3-fold increase expected by 2050, when 1896 hip fractures are expected nationally.

CONCLUSION: The surrogate FRAX model for Mongolia provides an opportunity to determine fracture probability within the Mongolian population and help guide decisions about treatment.

PMID:39955704 | DOI:10.1007/s11657-025-01501-y

Arch Osteoporos. 2025 Feb 16;20(1):25. doi: 10.1007/s11657-025-01510-x.

ABSTRACT

Injectable antiresorptive drugs may reduce refracture risk in older adults with previous fractures, though further research is needed to explore related factors, including the crucial role of consistent adherence.

PURPOSE: Osteoporosis increases fracture risk, particularly in older adults. Spinal and hip fractures are common and costly complications. To examine the effectiveness of parenteral antiresorptive medications-denosumab and zoledronate-in reducing refracture rates among older adults with prior spinal or hip fractures.

METHODS: A nationwide retrospective cohort study was conducted using data from Taiwan’s National Health Insurance Research Database (2011-2020). Patients aged 50 and older with spinal or hip fractures were divided into a treatment group (received zoledronate or denosumab) and a control group (no osteoporosis treatment). A 1:1 matching based on age, sex, and Charlson Comorbidity Index was performed. Kaplan-Meier method and Cox proportional hazards regression were used for analysis.

RESULTS: Out of 23,331 eligible patients, 582 were in the treatment group and 17,281 in the control group. After matching, 211 patients received zoledronate and 367 received denosumab. The treatment group showed a trend toward lower refracture risk compared to the control group, though not statistically significant. Hazard ratios were 0.63 for zoledronate and 0.80 for denosumab, indicating potential benefits. There was no substantial difference between the two medications.

CONCLUSION: This is the first real-world study to assess the effectiveness of complete adherence to parenteral antiresorptive medications in reducing the risk of refractures among older adults with prior spinal or hip fractures. However, further research is needed to confirm these findings and investigate long-term effects.

PMID:39955693 | DOI:10.1007/s11657-025-01510-x

Osteoporos Int. 2025 Feb 16. doi: 10.1007/s00198-025-07397-1. Online ahead of print.

ABSTRACT

The relationship between rheumatoid arthritis (RA) and fracture risk was estimated in an international meta-analysis of individual-level data from 29 prospective cohorts. RA was associated with an increased fracture risk in men and women, and these data will be used to update FRAX®.

INTRODUCTION: RA is a well-documented risk factor for subsequent fracture that is incorporated into the FRAX algorithm. The aim of this study was to evaluate, in an international meta-analysis, the association between rheumatoid arthritis and subsequent fracture risk and its relation to sex, age, duration of follow-up, and bone mineral density (BMD) with a view to updating FRAX.

METHODS: The resource comprised 1,909,896 men and women, aged 20-116 years, from 29 prospective cohorts in which the prevalence of RA was 3% or less (primary analysis) and an additional 17 cohorts with a prevalence greater than 3% (supplementary analysis). The association between RA and fracture risk (any clinical fracture, osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture) was examined using an extension of the Poisson regression model in each cohort and each sex, followed by random-effects meta-analyses of the weighted beta coefficients.

RESULTS: In the primary analysis, RA was reported in 1.3% of individuals. During 15,683,133 person-years of follow-up, 139,002 fractures occurred, of which 27,518 were hip fractures. RA was associated with an increased risk of any clinical fracture (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.35-1.65). The HRs were of similar magnitude for osteoporotic fracture and MOF but higher for hip fracture (HR = 2.23; 95% CI 1.85-2.69). For hip fracture, there was a significant interaction with age with higher HRs at younger ages. HRs did not differ between men and women and were independent of exposure to glucocorticoids and femoral neck BMD. Lower HRs were observed in the supplementary analysis cohorts, particularly in those with a high apparent prevalence of RA, possibly from conflation of RA with osteoarthritis.

CONCLUSIONS: A diagnosis of RA confers an increased risk of fracture that is largely independent of BMD, sex, and corticosteroids. RA should be retained as a risk factor in future iterations of FRAX with updated risk functions to improve fracture risk prediction.

PMID:39955689 | DOI:10.1007/s00198-025-07397-1

Orv Hetil. 2025 Feb 16;166(7):263-271. doi: 10.1556/650.2025.33233. Print 2025 Feb 16.

ABSTRACT

Bevezetés: A humán papillomavírus kimutatásán alapuló hatékonyabb méhnyakszűrés hazai bevezetésének tervezésekor a szakorvoshoz nem vagy ritkán eljutó nők közvetlen megszólítása, elérése is fontos. A védőnők képzése közel egy évtizede kiegészült a népegészségügyi célú méhnyakszűrés kompetenciájával. Célkitűzés: Egy korábbi hazai reprezentatív humán papillomavírus prevalencia felmérés adatai alapján elemeztük a védőnők által elért populáció jellemzőit és az általuk levett minták (n = 905) eredményeit, összehasonlítva a szakorvosok által szűrt populációval és eredményekkel (n = 3826). Módszer: Anonim kérdőíves felmérést és méhnyaki mintavételt végeztünk megyénként véletlenszerűen kiválasztott, összesen 169 szülész-nőgyógyász szakorvos és 40 védőnő segítségével ThinPrep edényzetbe Rovers Cervex-Brush Combi eszközzel. A laboratóriumi feldolgozás Neumann Confidence és Roche Linear Array klinikailag validált genotipizáló tesztekkel történt. Eredmények: A védőnői szűrésen részt vettek körében a páciensek átlagéletkora, az érettségivel nem rendelkezők és azok aránya, akiknél 3 évnél régebben vagy soha nem történt kenetcitológiai méhnyakszűrés, szignifikánsan magasabb volt, mint a szakorvosi szűrésen részt vevők körében. Az 55 év feletti korcsoportokban a védőnők mintája lényegesen közelebb állt a célcsoport populációs részarányához, mint a szakorvosoknál megjelenteké. Az eredménytelen minták aránya nem tért el szignifikánsan attól függően, hogy védőnő vagy szakorvos vette a mintát. A szakorvosok pácienseinél a pozitivitási arány szignifikánsan nagyobb volt, bár nagyobb arányban kaptak korábban humán papillomavírus elleni védőoltást. Megbeszélés: A községi mintákban az életkori hatás statisztikai kiküszöbölése után is látott alacsonyabb vírusprevalenciának mediátora lehetett a mintavételt végző szakember is, hiszen kóros előzményekkel rendelkező páciens nagyobb eséllyel fordulhat szakorvoshoz, mintsem hogy megvárja a védőnői megkeresést. Következtetés: Az iskolai oltási program elindulását, valamint a méhnyakrák előfordulásának korosztályi eloszlását figyelembe véve a szűrés szerepe sikeres oltási program mellett is legalább 20–30 évig jelentős marad. Az 50 év feletti, községben élő, alacsonyabb iskolázottságú célcsoport bevonása védőnőkön keresztül hatékonyabbnak bizonyult, mint szakorvosi rendelésen. Az erre képzett védőnők bizonyítottan eredményes mintavétellel, a nők egyéni felkeresésével, a szűréssel kapcsolatos kétségeik megválaszolásával egyedülálló szerepet játszhatnak a prevenciós célok megvalósulásában. Orv Hetil. 2025; 166(7): 263–271.

PMID:39955680 | DOI:10.1556/650.2025.33233