Nevin Manimala

J Cataract Refract Surg. 2025 Nov 26. doi: 10.1097/j.jcrs.0000000000001845. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate clobetasol propionate ophthalmic suspension (CPN) as treatment for inflammation and pain after cataract surgery.

SETTING: Nine outpatient surgery centers in the USA.

DESIGN: A randomized, double-masked, placebo-controlled, dose-selection, two-part study.

METHODS: After uncomplicated cataract surgery, participants were randomized to CPN 0.05% or placebo (1:1) twice daily (BID) for 21 days (Part A), or CPN 0.05%, CPN 0.1%, or their corresponding placebos (1:1:1:1) BID for 3 days, then once daily (QD) for 11 days (Part B). Primary efficacy endpoints were anterior chamber cell (ACC) count and ocular pain grade; secondary endpoints included visual acuity, anterior chamber flare (ACF) grade and number of participants rescued. Safety assessments included adverse events, ophthalmoscopy assessments and intraocular pressure (IOP).

RESULTS: In Part A, 45 participants were randomized (mean age 67.7 years; 71.1% female). In Part B, 87 participants were randomized (mean age 68.0 years; 63.2% female). CPN 0.05% BID for 21 days (Part A) produced statistically significant reductions of ACC count and ACF grade compared to placebo, with similar results after only 14 days of dosing. The CPN BID/QD regimens (Part B) were less efficacious than 0.05% BID. No participants on CPN were rescued. CPN was well tolerated, with an adverse event profile similar to placebo, including no meaningful IOP increases during up to 21 days of dosing.

CONCLUSIONS: CPN 0.05% BID for 3 weeks was safe and reduced ocular inflammation after cataract surgery.

TRANSLATIONAL RELEVANCE: CPN 0.05% administered twice a day has the potential to be a safe and effective treatment for inflammation after cataract surgery.

PMID:41329923 | DOI:10.1097/j.jcrs.0000000000001845

J Pers Disord. 2025 Nov;39(6):461-485. doi: 10.1521/pedi.2025.39.6.461.

ABSTRACT

Identity impairment is central to personality pathology generally, but less is known about how identity impairment appears differently across personality pathology. The AMPD lists a criterion for disorder-specific identity impairment for each personality disorder (PD), but these criteria have not been adequately empirically examined. N = 305 university students completed self-report measures of personality pathology (traditional DSM-5 and AMPD conceptualizations) and identity impairment (identity diffusion). We explored which identity diffusion items associated most strongly with each PD scale. Results were mixed. Predictions were partially supported in that at least one expected identity diffusion item emerged as most strongly associated with antisocial, avoidant, and borderline PDs. For narcissistic, obsessive-compulsive, and schizotypal PDs, predictions were not supported. Results were somewhat consistent between DSM Section II and AMPD scales for most PDs, except avoidant and obsessive-compulsive PD. We emphasize the need for further empirical study on disorder-specific identity impairment across personality pathology.

PMID:41329921 | DOI:10.1521/pedi.2025.39.6.461

J Pers Disord. 2025 Nov;39(6):437-460. doi: 10.1521/pedi.2025.39.6.437.

ABSTRACT

Research has sought to understand the relationship among childhood maltreatment, maladaptive personality, and antisocial behaviors. However, most of the literature overlooks possible gender differences by using primarily male samples. The current study examined these relationships, focusing on the mediating role of personality dysfunction, in samples of women who are incarcerated (N = 200) and undergraduate students (N = 187). Correlations revealed moderate to strong associations among childhood trauma, personality psychopathology, and antisocial behavior (rs = .31-.66). The findings demonstrated a mediation pathway from childhood trauma to BPD (β = .37) and ASPD/psychopathy (βs = .25-.34) to antisocial behavior (βs = .35-.67). This study provides a comprehensive understanding of the associations among childhood trauma, personality psychopathology, and antisocial behavior. Additionally, it expands existing research by presenting a mediation model, demonstrating the role of personality dysfunction in mediating the relationship between childhood maltreatment and antisocial behavior in women.

PMID:41329919 | DOI:10.1521/pedi.2025.39.6.437

Community Dent Health. 2025 Dec 2:265539X251401832. doi: 10.1177/0265539X251401832. Online ahead of print.

ABSTRACT

INTRODUCTION: Oral health, though linked with overall health and well-being, is often neglected in low- and middle-income countries such as India. Tooth loss, primarily caused by dental caries and periodontal disease, has been associated with malnutrition, obesity, cardiovascular disease, diabetes, and even mortality. Despite the increasing burden of multiple long-term conditions (MLTCs), limited research in India has explored the association between tooth loss and MLTCs. The study aimed to estimate the prevalence of complete tooth loss and assessed its association with MLTCs using nationally representative data from the second wave of the Study on Global Ageing and Adult Health (SAGE).

METHODS: The study utilized data from the second wave of SAGE conducted in 2015 in India. Data collection covered six states using a multistage stratified sampling approach. MLTCs were defined as the co-occurrence of two or more chronic conditions, assessed via self-reported diagnoses and clinical measurements. The analysis included 7,595 participants aged ≥45 years. Statistical analyses were conducted using weighted estimates and logistic regression models.

RESULTS: The prevalence of loss was 12%, while 25.1% of individuals had MLTCs. Among those with MLTCs, 15.4% experienced tooth loss. Tooth loss was significantly associated with MLTCs and ageing. The likelihood of tooth loss was higher in individuals with MLTCs [AOR: 1.30 (95% CI: 1.06-1.59), p-value: 0.012].

CONCLUSION: Tooth loss and MLTCs were found to be associated among adults aged ≥45 years in India, emphasizing the need to integrate oral health into chronic disease management strategies.

PMID:41329898 | DOI:10.1177/0265539X251401832

ACS Appl Mater Interfaces. 2025 Dec 2. doi: 10.1021/acsami.5c16811. Online ahead of print.

ABSTRACT

Emerging quantum information technologies demand robust, tunable, single photon sources. Solid-state single photon emitters (SPEs) in the two-dimensional material hexagonal boron nitride (hBN) offer unique advantages, including stability and integration potential, yet current fabrication methods lack precise control over the emitter placement and properties. In this work, we demonstrate a high-yield approach to patterning SPE arrays in hBN by combining focused ion beam (FIB) milling with chemical vapor deposition (CVD) of nanocrystalline graphitic carbon. Using statistical design and analysis of experiments, we systematically map a high-dimensional parameter space─spanning FIB exposure and CVD conditions─to identify the optimal regimes for SPE formation and tunability. Our method leverages widely available fabrication tools and provides critical insights into defect activation mechanisms, offering a scalable, reproducible path toward controllable quantum emitter synthesis. Beyond hBN, this approach opens the door to generating defect-based SPEs in other low-defect solid-state materials. The result is a practical and versatile platform for creating quantum light sources tailored for applications in communication, sensing, and computation.

PMID:41329897 | DOI:10.1021/acsami.5c16811

Health Aff (Millwood). 2025 Dec;44(12):1457-1465. doi: 10.1377/hlthaff.2025.00869.

ABSTRACT

The people most vulnerable to medical debt often face systemic barriers to health care that are further exacerbated by debt accumulation, creating a compounding effect leading to adverse health outcomes. This ecological panel study assessed associations among county-level medical debt and cancer screening, cancer mortality, and community-level health status. Medical debt data (from 2017, 2019, and 2021) from the Urban Institute Credit Bureau Panel were analyzed using generalized estimating equations with an exchangeable correlation structure and lagged exposure-outcome modeling. A total of 8,954 county-years were included. In multivariable analysis, each 5-percentage-point increase in medical debt was associated with a 0.43-percentage-point and a 1.35-percentage-point decrease in colorectal and breast cancer screening rates, respectively, and 10.9 per 100,000 population more deaths from cancers with guideline-recommended screening. Medical debt was consistently associated with worse health and cancer outcomes. Addressing this burden is important for improving population health and mitigating cancer-related disparities.

PMID:41329895 | DOI:10.1377/hlthaff.2025.00869

Health Aff (Millwood). 2025 Dec;44(12):1522-1529. doi: 10.1377/hlthaff.2025.00270.

ABSTRACT

This study examined state-level Medicaid hearing aid coverage for adults ages twenty-one and older across the United States. Using policy surveillance principles, we compiled a cross-sectional data set detailing hearing aid coverage policies from fifty states and Washington, D.C., as of December 31, 2023. We then merged these data with individual-level American Community Survey data to estimate national rates of Medicaid hearing aid coverage and identify how coverage varies according to demographic characteristics. We identified thirty-two states with Medicaid hearing aid coverage for adults, with substantial variability in policy features of that coverage. Approximately 70 percent of Medicaid beneficiaries ages twenty-one and older lived in a state with coverage. Women, working-age adults, and Black adults had slightly lower odds of coverage, whereas Hispanic and Latino and other or multiple race beneficiaries had higher odds of coverage. Expanding and standardizing Medicaid coverage of hearing aid benefits in line with best practices could improve access and utilization.

PMID:41329893 | DOI:10.1377/hlthaff.2025.00270

Microb Genom. 2025 Dec;11(12). doi: 10.1099/mgen.0.001566.

ABSTRACT

Introduction. Cholera, caused by Vibrio cholerae, remains a priority public health concern, particularly in developing countries. The first cholera outbreak in Zambia was documented in the 1970s, with recurring epidemics reported since then. In 2023, a cholera outbreak affected Zambia, particularly in districts bordering Malawi, Mozambique and the Democratic Republic of Congo, with significant cases reported in these neighbouring countries. This study aims to analyse cholera cases and isolates obtained during the 2023 epidemic, focusing on geographical distribution, genetic relatedness of isolates and their antibiotic resistance profiles.Methods. Stool samples were collected from patients presenting with cholera-like symptoms across three provinces of Zambia. A total of 98 samples were cultured on thiosulphate citrate bile salts sucrose agar, resulting in 32 sequenced V. cholerae isolates. Whole-genome sequencing was performed using Oxford Nanopore Technology, and phylogenetic inference was also achieved by the analysis of SNPs. Phenotypic antimicrobial resistance testing was conducted following Clinical and Laboratory Standards Institute guidelines. The genomic data were analysed for virulence factors and antimicrobial resistance profiles.Results. Of the 98 stool samples tested, 38 confirmed cholera cases were identified. A subset of 32 confirmed V. cholerae isolates, predominantly from the Eastern Province of Zambia (n=21), was selected for whole-genome sequencing. Genomic analysis revealed that all isolates belonged to the seventh pandemic El Tor lineage and the O1 serogroup, with two distinct clades identified corresponding to the 10th (T10) and 15th (T15) transmission events. Geographical analysis indicated a predominance of Ogawa serotypes in Eastern Province and Inaba in Northern Province. The virulence gene analysis confirmed the presence of key cholera toxin genes (ctxA and ctxB) and intestinal colonization factors. All isolates carried genes or mutations predicted to confer resistance to multiple antibiotics, including decreased susceptibility to ciprofloxacin, recommended for the treatment of cholera by the World Health Organization.Conclusion. The findings highlight the critical need for enhanced surveillance and targeted interventions to mitigate cholera outbreaks in Zambia. The emergence of resistant V. cholerae strains necessitates innovative strategies, including improved water sanitation, vaccination efforts and novel therapeutic approaches to combat this enduring public health threat.

PMID:41329510 | DOI:10.1099/mgen.0.001566

JAMA Netw Open. 2025 Dec 1;8(12):e2541939. doi: 10.1001/jamanetworkopen.2025.41939.

ABSTRACT

IMPORTANCE: Cognitive impairment and glycemic control have a bidirectional association. Understanding the impact of continuous glucose monitoring (CGM) vs self-monitoring of blood glucose (SMBG) is important for treating older adults with Alzheimer disease and related dementias (ADRD) and diabetes that is treated with insulin.

OBJECTIVE: To compare the risks of glycemic outcomes and related adverse events between CGM users and prevalent SMBG users in insulin-treated older adults with ADRD and diabetes.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, prevalent-new user cohort study utilized a nationwide, 15% random sample of Medicare claims data (Parts A, B, and D) from January 2016 to December 2020 to ensure balanced cohorts. Insulin-treated older adults (≥66 years) with ADRD and diabetes were included. Individuals in hospice care or with a professional CGM use were excluded. Analysis was carried out from August 2023 to December 2024.

EXPOSURE: Therapeutic CGM use vs prevalent SMBG use.

MAIN OUTCOMES AND MEASURES: Primary outcomes included hypoglycemia hospitalizations, hyperglycemia crisis, and all-cause mortality; falls and all-cause hospitalizations were secondary outcomes. Upper respiratory tract infections served as a negative control outcome. A 1:1 propensity score matching with a 0.25 caliper was carried out for confounding control. Cox proportional hazards models were used for outcome analysis.

RESULTS: In this cohort of 2022 insulin-treated older adults with diabetes and ADRD (1011 CGM users and 1011 SMBG users; mean [SD] age, 76.4 [6.7] years; 1133 female [56.0%]), CGM use was significantly associated with lower risk of all-cause hospitalization (hazard ratio [HR], 0.86; 95% CI, 0.76-0.96) and mortality (HR, 0.57; 95% CI, 0.48-0.67) compared with SMBG use. CGM use had lower point estimates for hypoglycemia hospitalization (HR, 0.66; 95% CI, 0.40-1.08) and falls (HR, 0.86; 95% CI, 0.68-1.08) and higher point estimates for hyperglycemia crisis (HR, 1.38; 95% CI, 0.99-1.94) vs SMBG use, but these findings were not significant. Exploratory subgroup analyses showed varied benefits. The negative control outcome showed no significant differences across analyses.

CONCLUSIONS AND RELEVANCE: In this cohort study of insulin-treated older adults with ADRD and diabetes, CGM use was associated with improved long-term clinical outcomes. Pragmatic (ie, evaluating the effectiveness of healthcare interventions in everyday settings) trials are needed to validate these findings and to assess the feasibility of CGM use in this population.

PMID:41329488 | DOI:10.1001/jamanetworkopen.2025.41939

JAMA Netw Open. 2025 Dec 1;8(12):e2544686. doi: 10.1001/jamanetworkopen.2025.44686.

ABSTRACT

IMPORTANCE: Despite a small prevalence, children with complex chronic conditions (CCCs) use substantial inpatient resources.

OBJECTIVE: To assess national trends in hospital discharges, bed days, and hospital charges for children with and without CCCs in the US from 2000 to 2022.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, repeated cross-sectional study used hospital discharge data from the Kids’ Inpatient Database (KID) from the years 2000, 2003, 2006, 2009, 2012, 2016, 2019, and 2022 for US children aged 0 to 18 years, excluding uncomplicated newborn discharges.

EXPOSURE: Presence of 0, 1, 2, or 3 or more CCCs.

MAIN OUTCOMES AND MEASURES: Trends in the hospital discharge rate per 100 000 children and percentage of total hospital discharges, bed days, and charges attributable to children with CCCs, identified with International Classification of Diseases, 9th Revision, Clinical Modification and International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification codes using Feudtner’s diagnosis code classification system, version 3. Survey weights were applied to estimate hospital discharges, bed days, and charges. Sociodemographic (eg, primary payer) and clinical (eg, technology dependence, mental health comorbidity) characteristics for each hospital discharge were also assessed.

RESULTS: Across all years, there were an estimated 26 342 497 hospital discharges, of which 54.1% (95% CI, 54.0%-54.2%) were among males and 55.4% (95% CI, 54.4%-55.8%) were for infants. From 2000 to 2022, the discharge rate per 100 000 US children increased by 24.3% (95% CI, 22.7%-26.3%), from 779 to 968, for children with 1 or more CCCs and decreased by 9.7% (95% CI, 9.4%-10.0%), from 3831 to 3459, for children with no CCCs. From 2000 to 2022, the percentage change in the hospital discharge rate varied by number of CCCs: a 3.8% (95% CI, 0.9%-6.0%) decrease was found for 1 CCC, a 60.9% (95% CI, 57.7%-65.5%) increase for 2 CCCs, and a 340.0% (95% CI, 332.6%-351.1%) increase for 3 or more CCCs. In 2000 and 2022, children with 1 or more CCCs accounted for 16.9% (95% CI, 15.7%-17.9%) and 21.9% (95% CI, 20.7%-22.9%) of hospital discharges, 32.0% (95% CI, 30.8%-33.1%) and 44.1% (95% CI, 42.6%-45.4%) of bed days, and 44.2% (95% CI, 42.6%-45.5%) and 59.5% (95% CI, 57.8%-60.9%) of hospital charges, respectively. From 2000 to 2022, the percentage of hospital discharges in children with 1 or more CCCs increased with gastroenterologic technology dependence (7.0% [95% CI, 6.0%-8.0%] to 14.4% [95% CI, 12.4%-16.4%]), neurodevelopmental or neurocognitive disorders (5.7% [95% CI, 4.8%-6.5%] to 13.5% [95% CI, 11.7%-15.2%]), and public insurance (40.9% [95% CI, 38.8%-42.9%] to 52.1% [95% CI, 50.2%-54.1%]).

CONCLUSIONS AND RELEVANCE: In this national, repeated cross-sectional study, the hospital discharge rate and the percentage of hospital resource use attributable to children with CCCs increased from 2000 to 2022, and these trends were mainly attributable to children with multiple CCCs. It is critical that health systems are equipped with the resources, staff, and payments to sustainably meet the increasing needs for inpatient care among children with CCCs.

PMID:41329487 | DOI:10.1001/jamanetworkopen.2025.44686