Nevin Manimala

Ophthalmic Physiol Opt. 2026 May 6. doi: 10.1007/s44402-026-00102-7. Online ahead of print.

ABSTRACT

PURPOSE: To develop a Scheimpflug-based image analysis technique to quantify tear exchange during scleral lens wear and investigate fluid reservoir tear dynamics during fenestrated lens wear.

METHODS: Nine healthy participants wore a scleral lens (KATT™, Capricornia Contact Lenses) with a single 0.3 mm diameter limbal fenestration in one eye for 90 min. Central (0-2.5 mm from the corneal apex) and peripheral (-1.0 to 0 mm from the scleral spur) stromal cornea oedema was measured using optical coherence tomography. Scheimpflug images were obtained during lens wear at multiple time points following the application of sodium fluorescein to the bulbar conjunctiva. These images were exported and annotated manually to select the region of interest (the fluid reservoir) from which the intensity of each pixel was extracted to provide a measure of fluorescent intensity (in arbitrary units [AU] on a scale of 0-255) throughout lens wear across the central 10 mm.

RESULTS: The coefficient of repeatability for central fluid reservoir intensity measurements was 7 AU (on a scale of 0-255 AU). Fluid reservoir fluorescent intensity varied with measurement location (p < 0.001), being greater towards the periphery (4 and 5 mm from the centre). On average, intensity differences between the peripheral and central fluid reservoir diminished within 10 min of sodium fluorescein application. Two patterns of tear dynamics were observed and were classified as low and high flow. Low flow participants (n = 6) exhibited greater central (3.72× more) and peripheral (2.25× more) corneal oedema, but the difference was not statistically significant.

CONCLUSIONS: The ingress and mixing of sodium fluorescein within the fluid reservoir stabilised between central and peripheral locations after 10 min of fenestrated scleral lens wear. Two patterns of tear dynamics were observed (low and high flow), with low flow participants exhibiting greater corneal oedema. Future research utilising the developed technique may provide further insights into tear exchange during scleral lens wear with different fenestration sizes and configurations.

PMID:42090093 | DOI:10.1007/s44402-026-00102-7

Insights Imaging. 2026 May 6;17(1):124. doi: 10.1186/s13244-026-02281-w.

ABSTRACT

OBJECTIVES: Gender equity in medicine remains a topic of increasing attention. The aim was to investigate if gender influences the radiology profession, with a focus on career progression, leadership roles, work-life balance, research activity and perceived barriers.

MATERIALS AND METHODS: An anonymous online survey consisting of 22 questions was distributed by the European Society of Radiology (ESR) to its members between October and December 2024. The survey covered demographics, work schedules, family responsibilities, career development, leadership roles, research involvement, and perceived personal experiences. Quantitative data were analyzed using descriptive statistics, chi-square test, and rate differences with confidence intervals. Open-ended responses were explored qualitatively using thematic analysis.

RESULTS: Among 830 respondents, 657 completed the questionnaire (63.3% female, 35.3% male, 1.3% others). Women more frequently reported caregiving responsibilities beyond childcare (4.1% vs 3%), longer parental leave (46.2% vs 21.5%), and experiences of harassing behaviors at work. Men held a higher proportion of leadership roles (33.2% vs 25.2%). Respondents involved in research were more likely to work > 30% extra hours (47.2% vs 29.0%). Although research activity rates were similar across genders, women more often reported barriers to attending conferences and a lack of protected research time. Career fulfillment increased with age among men but decreased among women. Gender was considered a career disadvantage by 44.5% of women versus 9.5% of men.

CONCLUSION: The survey reveals perceived gender disparities in radiology, particularly in leadership access, work conditions, and career satisfaction. Addressing structural barriers and promoting supportive workplace policies are essential to achieving true gender equity in the field.

CRITICAL RELEVANCE STATEMENT: Despite improvements in the last few decades, gender inequity remains present in radiology. Variability between geographical regions suggests that key critical areas can be addressed to promote improvement and support a more equitable professional environment.

KEY POINTS: Perceived gender disparities in radiology are present across career progression, leadership roles, and work-life balance. Women were significantly more likely than men to perceive gender as a career disadvantage (44.5% vs 9.5%; p < 0.0001 35.0% [95% CI: 28.9 to 41.1]). They reported slightly higher caregiving responsibilities and longer parental leave. Structural inequalities impact gender equity in radiology, requiring targeted institutional and cultural changes.

PMID:42090088 | DOI:10.1186/s13244-026-02281-w

Neurol Ther. 2026 May 6. doi: 10.1007/s40120-026-00945-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Ofatumumab, an anti-CD20 monoclonal antibody, is a high-efficacy disease-modifying therapy for relapsing multiple sclerosis (RMS). Although pivotal trials demonstrated substantial benefits, real-world data are required to confirm treatment persistence, effectiveness, safety, and biological markers of response in routine clinical settings. This study evaluated the real-world outcomes of ofatumumab in patients treated at a specialised multiple sclerosis (MS) centre in southeastern Spain, including exploratory analyses of B cell kinetics, comorbidity burden using the Charlson Comorbidity Index (CCI), and ethnicity.

METHODS: A retrospective observational study was conducted in adults with MS initiating ofatumumab between December 2022 and December 2025, with ≥ 6 months of continuous therapy. Demographic, clinical, radiological, laboratory, and pharmacological data were extracted from electronic medical records. Statistical analyses encompassed Kaplan-Meier estimates.

RESULTS: Eighty-seven patients were included (mean age 43 years; 75.9% female; 88.5% relapsing-remitting phenotype). Over a median 22-month follow-up, treatment persistence was 95.4%. Annualised relapse rate (ARR) declined from 0.48 pre-treatment to 0.03 on treatment. No evidence of disease activity (NEDA-3) was achieved in 93.1%, with no significant differences between treatment-naïve and previously treated patients. Sustained CD19⁺ B cell depletion was confirmed in all assessments. Immunoglobulin levels remained mostly stable. Ofatumumab was generally well tolerated: systemic injection-related reactions occurred in 29.9% and infections in 6.9%. Exploratory analyses showed no significant differences in relapse or magnetic resonance imaging outcomes by CCI category or ethnicity.

CONCLUSION: In this Spanish real-world single-centre cohort, ofatumumab demonstrated high persistence, substantial suppression of inflammatory activity, and a favourable safety profile in routine clinical practice. Sustained B cell depletion aligned with clinical and radiological stability. These findings support the real-world effectiveness of ofatumumab across diverse patient profiles and complement evidence from pivotal trials. Further prospective studies with broader populations and longer follow-up are warranted to refine understanding of long-term outcomes and determinants of treatment response variability.

PMID:42090082 | DOI:10.1007/s40120-026-00945-9

Ir J Med Sci. 2026 May 6. doi: 10.1007/s11845-026-04418-8. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the relationship between cervical area (CA) measured by two-dimensional (2D) transvaginal ultrasonography (TVUS) and the latency period in pregnancies complicated by preterm premature rupture of membranes (PPROM), and to compare its predictive performance with that of cervical length (CL).

METHODS: This retrospective cohort study included 164 singleton pregnancies with PPROM (24 + 0-32 + 3 weeks). Archived TVUS images obtained within 24 h of admission were reanalyzed in a blinded manner. CA (cm²), CL (mm), and cervical funneling were recorded. The latency period was defined as the time from membrane rupture to delivery and categorized as short (≤ 10 days) or long (> 10 days). Group comparisons, correlation analyses, receiver operating characteristic (ROC) curves, and multivariable logistic regression were performed to identify independent predictors.

RESULTS: Seventy-eight pregnancies had a short latency period. Both CL and CA were significantly lower in the short-latency group. Although the area under the curve (AUC) for CA was higher than that for CL (0.763 vs. 0.678), pairwise comparison using the DeLong test did not show a statistically significant difference (p = 0.064). In the multivariable analysis, cervical funneling (adjusted OR 10.777, 95% CI 4.456-26.063; p < 0.001) and CA (adjusted OR 0.701, 95% CI 0.598-0.822; p < 0.001) remained independent predictors of a short latency, whereas CL lost significance (p = 0.383). CA and CL showed a positive correlation with the latency period (p < 0.001).

CONCLUSIONS: CA measured by 2D-TVUS is an independent predictor of the latency period in PPROM and shows comparable discriminative ability to CL. Incorporating CA assessment may improve risk stratification and aid in timely perinatal management decisions in PPROM pregnancies.

PMID:42090061 | DOI:10.1007/s11845-026-04418-8

Ir J Med Sci. 2026 May 6. doi: 10.1007/s11845-026-04427-7. Online ahead of print.

ABSTRACT

BACKGROUND: Ischemic cardiomyopathy (ICM) and idiopathic dilated cardiomyopathy (DCM) shared common structural alterations with a high mortality from sudden cardiac death (SCD) and pump failure. Implantable cardioverter-defibrillator (ICD) has been confirmed both beneficial and cost-effective for primary prevention of SCD in patients with ischemic or non-ischemic heart diseases. The management of heart failure has improved due to the of implantation of ICD and cardiac resynchronization therapy-defibrillator (CRT-D). It remains unclear whether there is a difference in clinical effectiveness of primary prophylactic ICD implantation between patients with ICM and DCM.

METHODS: We conducted a retrospective, single-center study, which enrolled 53 DCM patients and 25 ICM patients with guideline indications for primary prophylactic ICD or CRT-D treatment. Primary endpoint was all-cause mortality and secondary outcomes included cardiovascular death.

RESULTS: During a median follow-up of 38.5 months, all-cause death occurred in 8 patients (32%) in the ICM group and 5 patients (9.43%) in the DCM group (P = 0.012). Cardiovascular death occurred in 5 patients (20%) in the ICM group and 3 patients (5.66%) in the DCM group (P = 0.052). Multivariable Cox regression analysis showed that cardiogenic mortality in the ICM group is higher than that in the DCM group (hazard ratio [HR] 0.119, 95% confidence interval (CI) 0.016 to 0.860, P = 0.035).

CONCLUSIONS: Among patients who received ICD implantation for the primary prevention of SCD, there is no statistical difference in benefits between DCM and ICM patients. However, compared with DCM patients, ICM patients have a higher cardiovascular mortality, due to more exposure to risk factors.

PMID:42090060 | DOI:10.1007/s11845-026-04427-7

Eur J Nutr. 2026 May 6;65(4):129. doi: 10.1007/s00394-026-03979-9.

ABSTRACT

PURPOSE: Evidence indicates that early-life nutrition may influence later cardiometabolic health, but most studies examine individual outcomes rather than multiple markers. This study assessed the relationship between macronutrient intake at 12 months and cardiometabolic health at ages 5-6 years in preschool children from the EDEN mother-child cohort.

METHODS: Macronutrient intake was derived from 3-day food records, standardized as SD. Body mass index z-scores (z-BMI) were calculated using International Obesity Task Force (IOTF) references. Four sex-specific cardiometabolic phenotypes, based on anthropometric and biological data, were previously identified: “Higher adiposity, blood pressure (BP) and insulin resistance (IR)”, “Higher IR and lower adiposity”, “Higher triglycerides, low-density lipoprotein cholesterol (LDL-c) and lower high-density lipoprotein cholesterol (HDL-c)”, and “Higher BP and lower adiposity”. Multivariable linear regressions examined associations between macronutrients and z-BMI (for 426 boys, 387 girls) and cardiometabolic phenotypes (256 boys, 221 girls).

RESULTS: In girls, higher fat intake at 12 months was linked to higher z-BMI at 5-6 years (β = 0.07 [95%CI 0.00; 0.15]). In boys, greater mono- and disaccharide intake was associated with a higher score on the “Higher triglycerides, LDL-c, and lower HDL-c” pattern (β = 0.22 [0.04; 0.41]), while in girls, it was associated with the “Higher BP and lower adiposity” pattern (β = 0.18 [0.01; 0.35]). Other macronutrients showed no significant associations.

CONCLUSION: In infancy, higher fat intake may contribute to a higher z-BMI in girls in early childhood, and higher sugar intake to less favourable cardiometabolic health.

PMID:42090019 | DOI:10.1007/s00394-026-03979-9

Eur J Orthop Surg Traumatol. 2026 May 6;36(1):186. doi: 10.1007/s00590-026-04765-3.

ABSTRACT

BACKGROUND: This study aims to describe a cohort of patients who underwent conversion to total hip arthroplasty (THA), comparing surgical approach and robotic assistance.

METHODS: Patients ≥ 18 years who underwent conversion to THA between January 1, 2015 and May 6, 2024, were retrospectively reviewed, and additionally contacted via telephone for updated patient reported outcome measures (PROMs), including the Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) questionnaire. Surgical approach and robotic assistance were per surgeon preference, with consideration for the approach of the previous hip surgery. Descriptive statistics were calculated, and continuous variables analyzed using the Student’s T-Test, the Wilcoxon Ranked Sum Test. Categorical variables were compared using Chi-Squared Tests and Fisher’s Exact Tests, and outcomes analyzed with logistic regression in R statistical software.

RESULTS: 83 patients met inclusion (53% anterior approach; 26.5% robotic assistance). Conversion via anterior approach demonstrated shorter operative times than posterior (by 45.9 min; p < 0.001), in addition to fewer postoperative transfusions (22.7% vs. 53.8%; p = 0.006). Length of stay (LOS), and fluoroscopy time were not significant. When stratified by previous surgery 37 patients were converted from prior intramedullary nail, 16 via the anterior approach. Mean operative time remained shorter (p = 0.003) and transfusion remained less (p = 0.015) compared to posterior conversion in this subset. Robotic assistance was associated with shorter operative times (by 44.9 min p < 0.001), and shorter LOS (p < 0.001). Zero robotic-assisted patients required transfusion within 24 h postoperatively compared to 50.8% of non-robotic cases (p < 0.001), although transfusion risk was not significant considering approach or robotic assistance after multivariable regression controlling for preoperative hemoglobin. PROMs were equivocal between compared groups (mean HOOS Jr 11.0 ± 5.1, response rate 42.2%).

CONCLUSION: Conversion THA demonstrates acceptable outcomes, with documented overall improvements in postoperative function. The anterior approach and robotic assistance were associated with significantly shorter surgical times, and less risk of transfusion, potentially demonstrating some advantage in this conversion scenario, although patient selection may have also influenced outcomes.

PMID:42090018 | DOI:10.1007/s00590-026-04765-3

World J Urol. 2026 May 6;44(1):343. doi: 10.1007/s00345-026-06428-8.

ABSTRACT

INTRODUCTION: Laser enucleation of the prostate (LEP) has become a standard treatment for benign prostatic obstruction, yet its adoption is limited by a steep learning curve and a lack of validated training models. This study aimed to evaluate the face and content validity of a bench-top simulator specifically developed for LEP training within the framework of the European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group.

METHODS: Fourteen expert endourologists assessed the simulator during the European Urology Residents Education Programme (EUREP) 2025. Face and content validity were evaluated using 4-point Likert questionnaires, structured using the ESU validation framework. Descriptive statistics and content validity indices (I-CVI, S-CVI/Ave, S-CVI/UA) were calculated to assess agreement across anatomical, procedural, and educational domains.

RESULTS: Face validity scores were high across all items (mean 3.57-3.86; ≥90% agreement). The overall S-CVI/Ave was 0.85 and S-CVI/UA 0.47. Domain-specific analysis showed strong content validity for procedural steps (S-CVI/Ave = 0.89) and educational/global domains (0.95), moderate validity for essential anatomy (0.81), and lower ratings for intraoperative conditions (0.69), primarily due to the absence of bleeding simulation. When restricted to core domains (procedural + educational), S-CVI/Ave improved to 0.91.

CONCLUSION: The simulator demonstrated strong face and content validity. Expert ratings indicated favorable perceptions of its realism, procedural similarity, and educational utility. These findings suggest that the simulator may be a useful component of a structured transurethral procedural training curriculum, although further construct validation is needed.

PMID:42090017 | DOI:10.1007/s00345-026-06428-8

Int Ophthalmol. 2026 May 6;46(1):226. doi: 10.1007/s10792-026-04094-8.

ABSTRACT

PURPOSE: To compare the intraoperative complication rates and incidence of postoperative day 1 (POD1) intraocular pressure (IOP) elevation in primary phacoemulsification cataract surgery performed by residents and staff surgeons in a teaching hospital and determine the risk factors associated with posterior capsule tear (PCT) and POD1 IOP elevation.

METHODS: This retrospective study included all cases of primary phacoemulsification in patients aged 18 years or older, performed by residents and staff surgeons from May 27, 2022, to May 31, 2023 in a tertiary eyecare center in Turkey. There were no exclusion criteria. Data collected included primary surgeon, level of experience, preoperative status of cases, intraoperative complications, other operative details and POD1 IOP measurements.

RESULTS: A total of 1500 surgeries were included; 68.8% were performed by residents. Overall intraoperative complication rates were similar in groups in simple and complex cases. There was no statistically significant difference in PCT rates between groups in simple (2.4% and 1.9%, p = 0.800) and complex cases (3.7% and 5.1%, p = 0.455). Rate of POD1 IOP elevation above 25 mm Hg was also similar in groups (22.7% and 22.6%, p = 0.903). Pseudoexfoliation + small pupil and special cataracts were significant risk factors for PCT among residents (p = 0.048 and p = 0.033, respectively). Pseudoexfoliation + small pupil, glaucoma or ocular hypertension and uveitis were significant risk factors for POD1 IOP elevation.

CONCLUSION: Overall intraoperative complication and PCT rates were comparable between residents and staff surgeons in both simple and complex cases. Resident involvement was not a risk factor for POD1 IOP elevation.

PMID:42090014 | DOI:10.1007/s10792-026-04094-8

Eur J Trauma Emerg Surg. 2026 May 6;52(1):159. doi: 10.1007/s00068-026-03207-3.

ABSTRACT

PURPOSE: Tibial plateau fractures (TPF) are often associated with non-bony injuries that may impair knee stability and long-term outcomes. However, it remains unclear in which patients preoperative MRI is indicated to detect these injuries, and clear recommendations for surgical decision making are lacking. This study aimed to develop a CT-based predictor of surgically relevant non-bony injuries.

METHODS: This retrospective single-center study included all intra-articular TPF treated between January 2022 and May 2025 at a Level I trauma center. Fractures were classified according to the 10-segment and three-column classifications. Operative reports were reviewed to identify non-bony injuries requiring surgical treatment. Descriptive statistics and multivariate logistic regression were performed to determine predictors of surgically relevant non-bony injuries.

RESULTS: Among 243 patients (mean age 49,3 ± 14,9 years), 34,6% had at least one surgically treated non-bony injury. Posterior column involvement was significantly associated with a higher injury rate (41,4%), particularly affecting meniscus (20,7%), Anterior cruciate ligament (ACL) (17,2%), and medial collateral ligament (MCL) (12,3%). The posterolateral-central (PLC) segment showed the highest segment-specific injury rate (37,6%) and was an independent predictor of ACL injury. Increasing fracture complexity was associated with a higher incidence of soft tissue injuries.

CONCLUSION: TPF should be regarded as complex intra-articular injuries rather than simple bone fractures. This study provides a CT-based tool to identify fracture patterns associated with surgically relevant non-bony injuries. These findings may support indications for preoperative MRI, guide treatment strategies, and help prevent poor outcomes and post-traumatic osteoarthritis.

PMID:42090008 | DOI:10.1007/s00068-026-03207-3