Category: Nevin Manimala

Int J Speech Lang Pathol. 2025 Nov 9:1-20. doi: 10.1080/17549507.2025.2582522. Online ahead of print.

ABSTRACT

PURPOSE: This systematic review examined the effectiveness and instructional characteristics of morphological awareness interventions for children aged 3 to 12 diagnosed with Developmental Language Disorder, in English- or Spanish-speaking contexts. It aimed to determine the outcomes of MA interventions and identify the instructional components most supported by evidence.

METHOD: Following PRISMA guidelines, a systematic search was conducted across five major databases (PsycINFO, PubMed, SCOPUS, Web of Science, and ERIC) between September and November 2024. Ten studies published between 1980 and 2024 met the inclusion criteria. The review synthesised results concerning both intervention outcomes and instructional features, using Frizelle and McKean’s (2022) Dose Form Framework.

RESULT: Only four studies reported statistically significant improvements in morphological awareness, with large effect sizes, indicating potential benefits of morphological awareness interventions for children with Developmental Language Disorder. However, many studies lacked rigorous methodology or failed to disaggregate outcomes for children with Developmental Language Disorder, limiting generalizability. Interventions with the strongest evidence base were those using explicit, clinician-directed instruction targeting affix identification and word construction.

CONCLUSION: The findings suggest promising but limited evidence supporting the effectiveness of morphological awareness interventions for children with Developmental Language Disorder. Further high-quality, controlled studies with detailed statistical reporting and consistent diagnostic labelling are needed. Structured, explicit instruction appears to be a critical feature of effective programs and should be prioritised in clinical and educational practice.

PMID:41206861 | DOI:10.1080/17549507.2025.2582522

Environ Geochem Health. 2025 Nov 9;47(12):557. doi: 10.1007/s10653-025-02855-5.

ABSTRACT

This study investigates how seasonal variability influences soil metal contamination, spatial distribution, sources, and associated health and ecological risks in a Pb-Zn mining district of southeastern Nigeria. Using ICP-MS analysis, multivariate statistics, and geospatial mapping, we examined Cu, Zn, Ni, Mn, Co, Fe, Cd, Cr, and Pb across dry and wet seasons. Mean metal levels across both seasons followed the order: Fe˃Pb˃Mn˃Zn˃Cr˃Cu˃Ni˃Co˃Cd. Multivariate evaluations predicted anthropogenic sources for Pb, Cu, Cd, and Zn, and geogenic sources for Fe, Co, and Ni. While the mean concentrations of Ni and Co aligned with regulatory and background thresholds, those of Cu, Fe, Cd, Cr, and Pb exceeded them. Non-carcinogenic and carcinogenic health risks were recorded for Cr and Pb across both seasons and exposure groups. Geospatial mappings recorded minimal seasonal variations for Zn hotspots, but high variability for Fe. This study highlights how seasonal variations affect metal pollution patterns in areas affected by artisanal mining. The findings help improve risk assessments, support efforts to protect public health, and guide policies that promote safer and more sustainable mining practices globally.

PMID:41206838 | DOI:10.1007/s10653-025-02855-5

Eur J Pediatr. 2025 Nov 9;184(12):741. doi: 10.1007/s00431-025-06594-8.

ABSTRACT

Deferred cord clamping (DCC) enhances placental transfusion, yet its feasibility in extremely preterm infants requiring resuscitation remains uncertain. Intact cord resuscitation (ICR) may allow simultaneous placental transfusion and stabilization. This study evaluated the feasibility and short-term outcomes of ICR in infants born at 23^0/7 to 25^6/7 weeks of gestation. This single-center case-series study compared two consecutive two-year periods before and after the introduction of ICR (September 2023) in extremely preterm infants requiring delivery room resuscitation. Infants born during the earlier period underwent early cord clamping (ECC). Specialized trolleys were not available; instead, stabilization was performed in a sterile polyethylene bag placed on the mother’s abdomen. The primary outcome was survival at day 7. Secondary outcomes included admission vital signs, laboratory parameters, early morbidities, and transfusion requirements. Twenty-two infants were analyzed (12 ECC, 10 ICR). Baseline characteristics were similar. Apgar scores at 5 and 10 min were higher in ICR (p = 0.02 and p < 0.001). On neonatal intensive care unit admission, mean arterial pressure and hemoglobin levels were significantly higher in ICR (respectively, p < 0.001 and 0.04). Red blood cell transfusion and inotrope use were more frequent in ECC, though not statistically significant. The incidence of any grade intraventricular hemorrhage (IVH) and grade ≥ 2 IVH did not differ. Early mortality occurred in 6 ECC infants (50%), but in none of the ICR infants (p = 0.04).

CONCLUSION: In this case-series, ICR was feasible without specialized equipment in extremely preterm infants and was not associated with adverse outcomes. The procedure appeared to support early hemodynamic stabilization and short-term survival, providing preliminary observations that warrant confirmation in larger prospective studies.

WHAT IS KNOWN: • ICR was shown to be feasible and safe in extremely preterm infants born at 23-25 weeks of gestation, even without specialized resuscitation trolleys. • Compared with early cord clamping, ICR was associated with higher Apgar scores, improved hemodynamic stability, higher hemoglobin levels, and enhanced early survival.

WHAT IS NEW: • Deferred cord clamping (DCC) increases blood volume, hemoglobin, reduces transfusion needs, and lowers intraventricular hemorrhage (IVH) risk in neonates. • Intact cord resuscitation (ICR) has been proposed to combine placental transfusion with timely stabilization, though its feasibility in this high-risk group is still debated.

PMID:41206833 | DOI:10.1007/s00431-025-06594-8

AIDS Behav. 2025 Nov 9. doi: 10.1007/s10461-025-04916-3. Online ahead of print.

ABSTRACT

The 2022 mpox outbreak significantly impacted gay, bisexual, and other men who have sex with men (MSM) in the U.S., with Los Angeles representing nearly 40% of California cases. Limited data exist on how MSM living with and without HIV navigated the outbreak and their decision-making regarding vaccination. Between November 2023 and March 2024, we conducted a mixed-methods study with 21 cisgender MSM in Los Angeles who completed a semi-structured interview and quantitative survey. Recruitment prioritized diversity in mpox vaccination history, HIV status, race, and ethnicity. Interviews were recorded, transcribed, and analyzed using thematic content analysis; surveys were analyzed using descriptive statistics. Participants had a mean age of 40 years; 33% were living with HIV; 48% identified as Black/African American or mixed-race, 38% White; nearly half identified as Hispanic/Latinx (48%); 57% reported receiving at least one mpox vaccine dose, and 38% reported two doses for maximum protection. Knowledge about mpox transmission, prevention, treatment, and outcomes varied. Participants self-reported hearing that mpox could be transmitted by skin-skin contact (76%), kissing (67%), engaging in oral sex (67%), and contact with semen (33%); 62% had heard there was a treatment for mpox, 14% thought that mpox was not curable, and 48% believed that mpox was likely to cause death. Psychosocial impacts were prominent at both individual and community levels, including fear and distress. Mpox vaccination was motivated by fear and a desire for protection, facilitated by accessible venues and peer influence. Barriers included initially poor availability of vaccine and the specific eligibility criteria requirements for vaccination early on in the epidemic. Logistical challenges, such as long wait times (> 2 h), work hours, lack of transportation, mistrust in research, and confusing initial rollout also presented unique barriers. LGBTQ+ community-based organizations and peer networks were the primary trusted source of mpox-related information. Most initially adopted risk reduction behaviors but generally viewed the mpox response more favorably than COVID-19 due to time differences in vaccine availability. Post-vaccination, many resumed pre-outbreak activities, feeling more prepared for future outbreaks despite some lingering concerns. Findings underscore varied mpox knowledge and significant psychosocial impacts, reminiscent of the early HIV epidemic. Key facilitators and barriers to vaccination highlight the critical reliance on LGBTQ+ community-based organizations and peer networks for sources of trustworthy information. Providing referrals to mental health counseling and other forms of support during vaccination is recommended.

PMID:41206825 | DOI:10.1007/s10461-025-04916-3

Odontology. 2025 Nov 9. doi: 10.1007/s10266-025-01252-9. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the effects of calcium hydroxide (CH), diclofenac sodium (DCS), and their combination (CH + DCS) as intracanal medicaments on post-endodontic pain in teeth diagnosed with symptomatic irreversible pulpitis. This study included 90 participants with one first or second mandibular molar with symptomatic irreversible pulpitis. They were randomly divided into three groups according to intracanal medicament (CH, DCS, CH + DCS) (n = 30). The participants were asked to rate their pain intensity on a VAS as none, mild, moderate, severe, or very severe after the 7 days following the first visit. Patients were also asked to record the number of prescribed analgesic medication tablets taken. Statistical analysis was performed using the Kruskal-Wallis test, the Friedman test, the Wilcoxon signed-rank test, and the Chi-square test. The significance level was established at 0.05. Ninety patients were analyzed at the 1-week follow-up. The pain scores gradually decreased after the first visit in all medication groups compared to the preoperative period (p < 0.05). DCS was more effective at reducing post-treatment pain when used alone than were DCH + CH and CH (p < 0.05). The number of patients who used postoperative analgesics was similar across the groups (p > 0.05). Compared with CH, the use of DCS alone as an intracanal medicament is more effective in reducing postoperative pain. The significant effect of DCS alone in reducing postoperative pain scores supports its consideration as an alternative to CH in endodontic treatment. ClinicalTrials.gov ID NCT06632015, Registration Date 10 July 2024 (retrospectively registered).

PMID:41206809 | DOI:10.1007/s10266-025-01252-9

J Manipulative Physiol Ther. 2025 Nov 8:S0161-4754(25)00022-3. doi: 10.1016/j.jmpt.2025.09.010. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and lidocaine phonophoresis combined or separated on trigger points in patients with tension-type headache (TTH).

METHODS: A double-blind randomized trial. A total of 60 participants with TTH were randomized into 4 equal groups. All groups received conventional treatment at the National Institute of Neuromotor System. Group A received conventional treatment only; group B received IASTM; group C received lidocaine phonophoresis; and group D received IASTM and phonophoresis. Visual analog scale (VAS), Arabic neck disability index (ANDI), headache frequency, and pressure pain threshold (PPT) were among the outcome measurements. All variables were measured before treatment and 4 weeks post-treatment.

RESULTS: Within the group’s analysis, multiple pairwise comparison tests revealed improvements at all measurement variables (P < .01) in all groups. Post-treatment, results showed a significant difference in groups D versus group A, groups B, and C with mean difference (MD) and 95% CI in VAS [3.18 (2.379-3.981), 1.133 (0.332-1.935), and 1.907 (1.105-2.708) respectively], ANDI [10.267 (8.382-12.151), 4.2 (2.316-6.084) 7 (5.116-8.884) respectively], headache frequency [1.9 (1.246-2.554), 0.8 (0.146-1.454), and 1.4 (0.764-2.054) respectively], and PPT. Additionally, there was a significant difference in all variables between group A and group B with MD in VAS, ANID, and headache frequency (2.047, 6.067, and 1.1 respectively) in favor of group B. Moreover, there was a statistically significant difference between group A and group C in VAS, ANDI, and PPT of left the suboccipital muscles on the side of group C. In group B versus group C, there was a statistically significant difference in ANDI and PPT of the left upper fibers of the trapezius muscles as P < .05 in favor of group B.

CONCLUSION: Both conventional treatments, IASTM, lidocaine phonophoresis, and the combination of IASTM and phonophoresis had statistically significant effects in relieving pain, increasing neck functional ability, decreasing headache frequency, and improving PPT in participants with TTP. Adding IASTM and lidocaine phonophoresis to conventional treatment was more effective than the other treatments.

PMID:41206797 | DOI:10.1016/j.jmpt.2025.09.010

Europace. 2025 Nov 8:euaf279. doi: 10.1093/europace/euaf279. Online ahead of print.

ABSTRACT

BACKGROUND: The prognostic significance of arrhythmias and conduction disorders on ambulatory ECG in recently diagnosed genetic versus non-genetic dilated cardiomyopathy (DCM) remains unknown.

OBJECTIVE: To compare the prevalence of abnormalities on ambulatory ECG monitoring between genetic and non-genetic DCM patients and evaluate the predictive value for malignant ventricular adverse events (MVAE).

METHODS: Clinical and ambulatory ECG data were collected from 354 genotyped DCM probands, with a median follow-up of 8 years (IQR:5-9years). MVAE was defined as ventricular fibrillation, sustained ventricular tachycardia, anti-tachy pacing, appropriate device therapy, or sudden cardiac death. C-statistics assessed the predictive performance of the regression models.

RESULTS: 123 (35%) patients carried a (likely) pathogenic variant. Abnormalities on ambulatory ECG were more frequent in genetic DCM patients (80%) compared to non-genetic DCM (67%; p=0.013). Permanent atrial fibrillation (perAF), paroxysmal supraventricular tachycardia (parox-SVT) and non-sustained ventricular tachycardia (NSVT) were more frequent in genetic DCM patients (p=0.041, <0.001 and <0.001). Structural cardiac parameters showed minimal group differences. Using Cox-proportional hazard analyses to predict MVAE, ambulatory ECG variables (perAF, AV-block, NSVT, >500 premature ventricular complexes (PVC)/24 hours) had an AUC of 0.768 in genetic and 0.628 in non-genetic DCM patients (p=0.044). PVC burden was only predictive for MVAE in genetic DCM. Adding clinical variables provided little incremental predictive value for genetic versus non-genetic DCM (AUC Δ+0.004 versus Δ+0.150, respectively).

CONCLUSION: Ambulatory ECG monitoring abnormalities are prevalent in genetic DCM patients. In contrast to non-genetic DCM patients, ambulatory ECG parameters have an important predictive value to determine the risk of MVAE in genetic DCM patients.

PMID:41206691 | DOI:10.1093/europace/euaf279

Hum Reprod. 2025 Nov 7:deaf215. doi: 10.1093/humrep/deaf215. Online ahead of print.

ABSTRACT

STUDY QUESTION: What are the satisfaction levels, as defined by emotional comfort or contentment, of adult individuals conceived via donor-assisted reproduction concerning the method, timing, and circumstances surrounding the disclosure/discovery of their conception?

SUMMARY ANSWER: Inadvertent discovery and older age at the time of disclosure of donor-conceived status are associated with lower rates of satisfaction among donor-conceived individuals.

WHAT IS KNOWN ALREADY: The proliferation of commercial DNA testing has resulted in many donor-conceived people learning inadvertently of their donor origins. As a result, donor-conceived people, healthcare professionals, and parents seek information and research about best disclosure practices and outcomes.

STUDY DESIGN, SIZE, DURATION: A survey-based cross-sectional cohort study from 2022 to 2023 was conducted involving 530 participants, of whom 422 completed the survey.

PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 546 people ages 18 years and over opened the survey, with 530 people qualifying to complete the survey as donor-conceived persons (DCPs). Four hundred and twenty-two DCPs (79.6%) completed the survey. Descriptive statistics were applied, and data distributions were analyzed for a selection of appropriate statistical tests; parametric tests such as Student’s t-test or ANOVA, and non-parametric tests such as Mann U Whitney or Kruskal-Wallis Rank Sum test were utilized as applicable, for comparing continuous data between groups. Multivariable logistic regression analyses were used to examine satisfaction levels, adjusting for potential confounders.

MAIN RESULTS AND THE ROLE OF CHANCE: After accounting for age at discovery, sex, the origin of disclosure, and education, individuals with early intentional disclosure were more than three times as likely to experience disclosure satisfaction as those with late unintentional disclosure/inadvertent discovery (P-value = 0.005).

LIMITATIONS, REASONS FOR CAUTION: Lack of ethnic diversity among survey respondents, and limited control over reposting of the survey to other sites, potentially contributing to sampling bias.

WIDER IMPLICATIONS OF THE FINDINGS: Preliminary but substantial evidence that early, intentional disclosure to DCPs results in greater satisfaction and acceptance. This data will ultimately assist all stakeholders, including reproductive health professionals and parents in family-building counseling and decision-making.

STUDY FUNDING/COMPETING INTEREST(S): None.

TRIAL REGISTRATION NUMBER: N/A.

PMID:41206682 | DOI:10.1093/humrep/deaf215

Pain Med. 2025 Nov 7:pnaf149. doi: 10.1093/pm/pnaf149. Online ahead of print.

ABSTRACT

OBJECTIVE: People with migraine have a higher prevalence and severity of insomnia. We examined the relationship between insomnia severity and migraine-related disability (MIDAS) and migraine-specific quality of life (MSQv2.1).

METHODS: We conducted a post-hoc analysis of a pilot randomized controlled study assessing the RELAXaHEAD application in those with insomnia and comorbid migraine. Descriptive statistics were used to summarize demographic and clinical characteristics. Linear mixed model analysis was conducted to evaluate Insomnia Severity Index (ISI) as a predictor of each MSQv2.1 domain and MIDAS.

RESULTS: Forty-two participants completed baseline and at least one follow-up survey. Mean age was 43.8 years (SD 12.6) and the majority (85.7%) were female. Most participants (81.0%) had severe migraine-related disability (median baseline MIDAS, 32 (IQR 52)). Over half (54.8%) of participants had moderate clinical insomnia (mean baseline ISI, 18.5 (SD 4.6)). Baseline median MSQv2.1 scores were 44.3 (IQR 31.4) for Role Function-Restrictive (RFR), 65.0 (IQR 45.0) for Role Function-Preventive (RFP), and 46.7 (IQR 46.7) for Emotional Function (EF). The effect of ISI on MIDAS was statistically significant (rate ratio (RR)=1.10, p < 0.05, 95%CI [1.028, 1.171], meaning each one-point increase in ISI was associated with a 10% higher MIDAS score). Additionally, a 1-point increase in ISI was associated with a decrease of 1.2 points in MSQ-RFR (B=-1.205, p = 0.001),1.0 point in MSQ-RFP (B=-0.981, p = 0.020), and 1.4 points in MSQ-EF (B=-1.66, p = 0.001).

CONCLUSIONS: Our study revealed significant associations between insomnia severity and migraine-related disability and quality of life, highlighting the importance of prevention and sleep intervention for patients with migraine.

PMID:41206664 | DOI:10.1093/pm/pnaf149

Int J Epidemiol. 2025 Oct 14;54(6):dyaf175. doi: 10.1093/ije/dyaf175.

ABSTRACT

BACKGROUND: Despite an incidence increase in recent decades, the etiology of testicular germ cell tumors (TGCT) remains poorly understood. The hypothesis of a two-stage development, combining initial alteration in utero followed by malignant transformation later in life, has been suggested. This study examined the association between cumulative lifetime occupational and para-occupational solvent exposure and TGCT risk.

METHODS: The French multicenter case-control study TESTIS included 454 cases and 670 controls. Participants provided information on their occupational history; participants’ mothers (N = 547) provided information on their own and the father’s occupational history. Solvent exposure was assessed by using the Matgéné job-exposure matrices. The influence of the parental and subject’s occupational exposures over the lifetime and at different periods (i.e. fetal life/infancy; childhood; adolescence; subject’s exposure) on TGCT was examined. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by using conditional logistic regression models.

RESULTS: An OR for TGCT of 1.03 (95% CI 0.59-1.79) was found for the lifetime solvent exposure. When each period was examined individually, the results showed an increased TGCT risk in adult males who were occupationally exposed to trichloroethylene (OR = 3.09; 95% CI 1.25-7.65); fuels and petroleum-based solvents (OR = 1.91; 95% CI 1.21-3.02); diesel, kerosene, and fuel oil (OR = 2.26; 95% CI 1.16-4.41); and ketones and esters (OR = 1.66; 95% CI 1.02-2.71), and suggested a positive association with solvent exposure during adolescence (OR = 1.77; 95% CI 0.95-3.31).

CONCLUSION: Overall, this study did not suggest a substantial role of cumulative lifetime solvent exposure and TGCT risk. The results showed an increased TGCT risk associated with solvent exposure during adulthood. Indirect exposure to certain solvents during adolescence might also promote TGCT development.

PMID:41206641 | DOI:10.1093/ije/dyaf175