Nevin Manimala

Int J Ophthalmol. 2025 Aug 18;18(8):1498-1505. doi: 10.18240/ijo.2025.08.11. eCollection 2025.

ABSTRACT

AIM: To determine the differences in levels of systemic C-reactive protein (CRP) in patients with geographic atrophy (GA) and sex-based differences in CRP levels.

METHODS: Blood samples from patients with GA and controls were collected in a prospective age-related macular degeneration (AMD) registry from August 2014 to June 2021. AMD was confirmed using multimodal imaging and the Beckman and Consensus of Atrophy Meeting criteria for GA. High-sensitivity serum CRP levels were measured using an automated nephelometer. A non-parametric (rank-based) linear regression model was fit with an interaction between sex and GA.

RESULTS: There were 97 GA patients and 139 controls, with females comprising 55% and 66% of each cohort, respectively. There is no difference in CRP between cases and controls, with a median (interquartile range) of 1.2 (0.6-2.6) mg/L in GA patients versus 1.3 (0.8-2.9) mg/L in controls (P=0.52). Although females had higher CRP levels compared to males in both the GA and control groups, this difference did not reach statistical significance after adjustment for multiple comparisons.

CONCLUSION: There is no significant difference in systemic CRP levels between GA cases and controls.

PMID:40827292 | PMC:PMC12311458 | DOI:10.18240/ijo.2025.08.11

Aesthetic Plast Surg. 2025 Aug 18. doi: 10.1007/s00266-025-05154-7. Online ahead of print.

ABSTRACT

BACKGROUND: The postauricular injection technique is a needle-based technique that places soft tissue fillers behind the ears into the supra-periosteal plane of the mastoid process of the temporal bone. The resulting clinical effect pushes the auricles more laterally mimicking the inverse effects of a surgical otoplasty.

OBJECTIVE: The purpose of this study is to investigate the aesthetic outcome of the postauricular injection technique by having the treatment results evaluated by several international, independent, and blinded reviewers.

METHODS: 2D frontal before and after images of 30 Chinese patients (29 females, 1 male) with a mean age of 37.70 (9.4) years and a mean BMI of 19.56 (1.2) kg/m² were collected, randomized to sequence and patient order, and sent out to 14 independent international raters who were not involved in the treatment planning or treatment process. The mean follow-up period for the picture-based rating was 2.73 (2.0) months whereas the average amount of product administered per facial side was 4.08 cc (1.7).

RESULTS: This study revealed that the postauricular injection technique was evaluated to increase attractiveness, decrease un-attractiveness, and result in a younger facial appearance. Individual and detailed features like facial shape, facial fullness, temporal volume, midfacial volume, jawline contouring failed to reach statistical significance despite showing improvements.

CONCLUSION: This study revealed that the postauricular injection technique is able to increase facial attractiveness, decrease facial un-attractiveness, and result in a younger facial appearance in a Chinese patient population. Individual and detailed features like facial shape, facial fullness, temporal volume, midfacial volume, and jawline contouring failed to reach statistical significance despite showing improvements. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:40826291 | DOI:10.1007/s00266-025-05154-7

Lasers Med Sci. 2025 Aug 19;40(1):337. doi: 10.1007/s10103-025-04582-w.

ABSTRACT

This study primary aimed to evaluate the effect of high-intensity laser therapy (HILT) on the elasticity of the supraspinatus tendon in participants with subacromial impingement syndrome (SIS) and secondary aimed to evaluate the effect of HILT on pain and function. This randomized controlled double-blind study included 66 participants diagnosed with SIS and were randomly assigned into HILT group (HILT and physical therapy) and control group (sham HILT and physical therapy) and received 10 sessions (five days a week during two weeks). Supraspinatus tendon elasticity was measured by shear wave elastography (SWE). Pain and function were assessed by visual analog scale (VAS) and shoulder pain and disability index (SPADI), respectively. Measurements were made at baseline and after treatment. The minimal clinically important difference (MCID) was accepted as 1.37 for VAS and 13.2 for SPADI. There was no difference in SWE measurements before and after treatment in both groups (p > 0.05). VAS and SPADI showed clinically and statistically significant improvement in the HILT and control groups (p < 0.001). The r value for VAS and SPADI in the HILT group was calculated as 0.97; and 0.97 for VAS and 0.96 for SPADI in the control group. A statistically significant difference was found in VAS and SPADI in the HILT group compared to the control group (p = 0.010, p < 0.001, respectively). However, the differences were not clinically significant (mean differences 0.5 and 6.41, respectively). This study concluded that HILT applied together with physical therapy had no effect on tendon elasticity in the short term. Besides, HILT combined with physical therapy is statistically more effective in reducing pain and improving function than physical therapy alone.

PMID:40826289 | DOI:10.1007/s10103-025-04582-w

Sci Rep. 2025 Aug 18;15(1):30176. doi: 10.1038/s41598-025-15943-4.

ABSTRACT

This paper develops an SEIR-type control model for an optimal control problem (OCP) related to rumor propagation (RP), aiming to address three control strategies designed to reduce the amount of false information and defrauders in online social networks (OSNs). We explore an OCP to analyze the behavior of uninformed individuals against false rumors, the effectiveness of filtering information propagation within OSNs, and the implementation of punitive measures against defrauders. To solve this OCP, we employ a hybrid discretization-metaheuristic approach that integrates the collocation method to transform the OCP of the RP model into a nonlinear programming (NLP) with a Botox optimizer for the NLP to detect the optimal control, state variables, and objective functional. By collecting data on RP from relevant existing literature, we can better verify the SEIR-type control model to stop RP. Numerical simulations confirm the meaningful effect of three strategies that reduce the persons’ exposure to rumors and the defrauder’s tendency to mislead individuals over OSNs in controlling and stopping the RP.

PMID:40826266 | DOI:10.1038/s41598-025-15943-4

Sci Rep. 2025 Aug 18;15(1):30172. doi: 10.1038/s41598-025-15725-y.

ABSTRACT

Breast cancer-related lymphedema (BCRL) adversely affects the daily performance and quality of life (QoL) in affected patients. This study aimed to determine the Impact of a self-management mobile application on quality of life and limb circumference in women with BCRL. This randomized clinical trial was conducted on 180 patients with BCRL in Shiraz, Iran, from May 2023 to January 2024. The participants were randomly assigned to the intervention (n = 90) and control (n = 90) groups. The control group received the normal treatments at the lymph clinic. In addition to the usual clinic treatments, the intervention group had access to a mobile application for 3 months. The primary outcomes were QoL, assessed using the Lymphedema Life Impact Scale (LLIS), and the difference in arm circumference, measured using a standard tape. After the intervention, the mean (SD) LLIS score in the intervention group was 29.1 (10.7), which was significantly lower than the control group with 39.3 (15.5). This difference was statistically significant (p < 0.001), indicating a substantial improvement in QoL in the intervention group compared to the control group. Additionally, the intervention group showed a lower mean (SD) arm circumference difference of 2.18 (1.4) compared to the control group with 3.78 (2.6). This result also was statistically significant (p < 0.001). Therefore, we recommend using the application to support self-management among women with BCRL.

PMID:40826265 | DOI:10.1038/s41598-025-15725-y

Neurol Ther. 2025 Aug 19. doi: 10.1007/s40120-025-00812-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Medication overuse headache (MOH) is incurred by the excessive use of acute medications, including over-the-counter (OTC) treatments. This study aimed to characterize the burden, management, and treatment satisfaction of patients with migraine with or without MOH in Japan.

METHODS: Data were derived from the Adelphi Migraine Disease Specific Programme (DSP)™, a cross-sectional survey conducted in Japan from August 2023 to February 2024. Physicians provided data for consecutive patients, including demographics, clinical characteristics, current treatment, OTC treatment usage, and treatment satisfaction. Patients voluntarily reported their symptom burden, migraine pain severity, and treatment satisfaction. Alignment between physician and patient regarding treatment satisfaction was assessed using Cohen’s weighted kappa statistics and multivariable regression models.

RESULTS: Overall, 122 physicians provided data for 820 patients with migraine, 7.0% (n = 57) of whom had a diagnosis of MOH; 41.5% (n = 340) of patients self-reported data, with 3.2% (n = 11) having a diagnosis of MOH. Patients with MOH were more likely to experience chronic migraine (79%, n = 45), greater migraine frequency, and more severe migraine than those without MOH. Ninety percent of both groups received acute treatment. Patients with MOH were significantly more likely to receive preventive treatment than those without MOH (86% vs 56.6%, p < 0.001). OTC medication use was reported at 3.3% by physicians and 11.2% by patients. The alignment between physician and patient treatment satisfaction was low for acute treatment. The exploratory model analysis indicated that OTC use may have contributed to this misalignment.

CONCLUSION: Our study revealed that the alignment regarding treatment satisfaction with acute medications is low. OTC treatment usage may have inflated physician satisfaction with prescribed acute medications and caused a discrepancy regarding satisfaction of patients with MOH. To improve patient outcomes, it is essential to align drug effectiveness ratings between physicians and patients by enhancing communication and mutual understanding.

PMID:40826258 | DOI:10.1007/s40120-025-00812-z

Clin Rheumatol. 2025 Aug 18. doi: 10.1007/s10067-025-07637-z. Online ahead of print.

ABSTRACT

OBJECTIVES: Through this meta-analysis, we aim to provide an overview and statistical synthesis of the prevalence of MetS and its components in psoriatic arthritis (PsA) compared to the general populations, patients with cutaneous psoriasis (PsO), and patients with other inflammatory arthropathies.

METHOD: A search was conducted in Ovid Medline, Web of Science, and Scopus up to February 2024. Original articles investigating the prevalence of MetS in PsA in adults compared to one or more comparison populations were included. Bias risk was assessed by means of a funnel plot. The data was analyzed by means of a random effects model and presented in forest plots.

RESULTS: Of 1526 articles in the original search, 20 relevant were identified. Meta-analyses showed an increased prevalence of MetS in PsA compared to the general population, rheumatoid arthritis (RA), and ankylosing spondylitis (AS) (LogOR 0.93, 0.63, and 1.04, respectively). Meta-analysis showed no difference in the prevalence of MetS in PsA compared to PsO (LogOR 0.15, I² 0.63). Meta-analysis of the prevalence of the different components of MetS in PsA compared to RA showed an increased prevalence of central obesity, hypertriglyceridemia, impaired glucose tolerance, and diabetes mellitus.

CONCLUSIONS: PsA was associated with an increased risk of MetS compared to the risk in the general population, in RA and in AS, respectively. This emphasizes the importance of screening for and taking necessary measures to prevent MetS in patients with PsA. Key Points • Patients with PsA have an increased risk of MetS compared to the general population as well as patients with RA or AS. • According to this meta-analysis, the risk of MetS is the same in patients with PsA as in patients with PsO.

PMID:40826245 | DOI:10.1007/s10067-025-07637-z

Sci Rep. 2025 Aug 18;15(1):30205. doi: 10.1038/s41598-025-16083-5.

ABSTRACT

With rapid industrialization, the accumulation and contamination of heavy metal(loid)s in soil often has occurred. However, the accumulation of heavy metal(loid)s in soil in non-industrial and tourist cities with high population densities is not well known. Therefore, the Macao Special Administrative Region (Macao SAR) was taken as an example to investigate the spatial and temporal changes in the characteristics of soil heavy metal(loid)s in non-industrial and tourist cities. The total concentrations of heavy metal(loid)s (As, Co, Cd, Cr, Cu, Pb, Ni, Hg, and Zn) in soil as well as the ecological risk in different functional areas and geographic locations were studied by combining statistical analysis, the land accumulation index, and the potential ecological risk index. Finally, the data in 2018 and 2023 were compared. The results show that in terms of spatial distribution, the high CVs (coefficients of variation) of 0.67 and 0.73 for Cr and Hg, respectively, showed Cr and Hg were more likely to have point sources of contamination. The skewness value of 0.16 for Zn suggests that the distribution may be slightly skewed and flat, with a more uniform distribution, probably due to the high-density distribution of the population and atmospheric deposition. Compared with other areas, heavy metal(loid) concentrations in soils were generally higher in the Macao Peninsula, which may be related to the higher population of waste incineration plants and residential areas located there. Geographically, Hg concentrations in soils were higher near the airport and transportation areas than in other areas. From 2018 to 2023, heavy metal(loid)s (except Zn) in the soils of Macao did not increase significantly but showed a decreasing trend due to tourism-oriented activities, high rainfall, the absence of industry, and the COVID-19 pandemic. Cr, Cd, Zn, and Hg occur more frequently in the lower concentration ranges than the other heavy metal(loid)s and generally show decreasing trends. Although the potential ecological risk of heavy metal(loid)s in Macao was generally low, As had the highest potential risk. Most of the lightly contaminated sites (62%) had a higher geo-accumulation index of Zn than for the other heavy metal(loid)s. This paper can be used as the data support for future research on soil heavy metal(loid) distribution and government policies for non-industrial cities.

PMID:40826219 | DOI:10.1038/s41598-025-16083-5

CJEM. 2025 Aug 18. doi: 10.1007/s43678-025-00990-7. Online ahead of print.

ABSTRACT

BACKGROUND: Patients presenting to the emergency department (ED) with hip fractures are typically treated with opioids, which are associated with adverse events such as delirium and respiratory depression. The fascia iliaca compartment block (hereafter fascia iliaca block) is a regional analgesia technique which avoids these negative outcomes. We sought to increase the rate of use of this technique to 50% of all patients with hip fractures who presented to our EDs within an 18-month period.

METHODS: We held three Plan-Do-Study-Act cycles designed in accordance with surveys sent to our physician group. The first cycle consisted of the dissemination of educational materials and standardization of equipment carts. Next, we held educational sessions for staff and trainee physicians. The third cycle consisted of additional education, Audit and Feedback methodology and incentives. Our outcome measure was the rate of fascia iliaca blocks performed. We tracked the number of unique physicians performing the fascia iliaca block as well as physician-reported comfort with the procedure for our process measures. Our balancing measure was the rate of adverse events.

RESULTS: We went from a baseline rate of 2.0% to 22.6% of patients receiving fascia iliaca blocks. The number of physicians doing this increased from 6 pre-project to 35. Only one adverse event occurred (arterial puncture), which did not cause any significant patient harm. Our statistical process control chart revealed special cause variation in the form of a shift.

CONCLUSION: Although we did not meet our goal, we were able to significantly improve the rate of fascia iliaca blocks performed at our center. This was largely achieved through educational interventions. Our approach can be adapted by other centers looking to pursue a similar project.

PMID:40826210 | DOI:10.1007/s43678-025-00990-7

Skeletal Radiol. 2025 Aug 18. doi: 10.1007/s00256-025-05014-0. Online ahead of print.

ABSTRACT

OBJECTIVE: Distal clavicular osteolysis (DCO) is a commonly encountered cause of shoulder pain resulting from repetitive overuse or antecedent trauma, classically described in young male weightlifters. We propose a variant of DCO in which osteolysis spans the acromioclavicular joint, involving both the anterior acromion and the distal clavicle.

MATERIALS AND METHODS: A retrospective PACS query identified patients with DCO on shoulder MRIs performed at ≥ 1.5 T over a 1-year period. After inclusion/exclusion criteria were applied, each case was reviewed in a blinded fashion to assess for additional findings of osteolysis involving the acromion. Demographics and patient questionnaire data were recorded and analyzed for statistical significance between groups.

RESULTS: A total of 128 cases of DCO were identified in 127 patients (93 males). Mean age was 39.5 years (SD 11.3 years). Average symptom duration was 409 days (13.4 months). Per questionnaires, 45.3% had a history of antecedent trauma, 62.5% reported lifting weights, 38.3% reported overhead sports, and 32.0% reported repetitive activities. Of the 128 cases, 42 (32.8%) had additional findings of osteolysis involving the acromion. Acromial involvement was seen more commonly in males (p = 0.049). Other than sex, maximum bench press weight was the only statistically significant factor associated with acromial involvement (p = 0.027).

CONCLUSION: We identified a variant of DCO with osteolysis involving the acromion in addition to the distal clavicle. Other than male sex, maximum bench press weight was the only significant factor associated with acromial involvement, suggesting that increased load bearing may contribute to more extensive osteolysis.

PMID:40826189 | DOI:10.1007/s00256-025-05014-0