Category: Nevin Manimala

Orphanet J Rare Dis. 2025 Nov 7;20(1):567. doi: 10.1186/s13023-025-04098-0.

ABSTRACT

BACKGROUND: Fabry disease (FD) is an X-linked disorder caused by deleterious variants in GLA. Cardiovascular disease (CVD) causes premature mortality in FD. Hope for aspirin (acetylsalicylic acid, ASA) to reduce CVD risks in FD as primary prevention may have been tempered by the 2018 ARRIVE, ASCEND, and ASPREE clinical trials. It is unclear how new ASA guidance applies to FD patients, who have a high rate of young-onset, small vessel stroke compared with the general population.

METHODS: Longitudinal data spanning 2007-2023 from patients in the Canadian Fabry Disease Initiative (CFDI) were analyzed retrospectively. Incident stroke and transient ischemic attack (TIA), other CVD events, FD-specific risk factors, and ASA/antiplatelet (“ASA/AP”) prescription before and after 2018 were compared between groups who never had an event (“primary prevention group”) to those who had incident stroke/TIA during the study. Stroke/TIA rates were compared within CFDI by sex and GLA variant severity, and in the CFDI compared to Canadian statistics by sex. Ten-year atherosclerotic CVD (ASCVD) risk was calculated using the 2013 ACC/AHA risk calculator. ASA/AP prescription rate was compared before and after 2018.

RESULTS: Out of 641 patients, 57 had an incident stroke/TIA during the study, and 193 with complete data remained in the primary prevention group. Stroke/TIA rates were significantly higher among male patients (0.026 events per patient-year) than females (0.0098 events per patient-year), and higher among patients with severe GLA variants (males: 0.031 events per patient-year, females: 0.0096 events per patient-year) compared to those with attenuated variants (males: 0.011 events per patient-year, females: 0.0088 events per patient-year). No patients under 60 years at their incident stroke/TIA had high (≥ 10%) calculated 10-year ASCVD risk. Fewer patients were prescribed ASA/AP for primary prevention after 2018.

CONCLUSIONS: There was a high incidence of stroke/TIA in the younger CFDI cohort compared to the general Canadian population, despite low levels of traditional vascular risk factors as represented in 10-year estimated ASCVD risk. Primary prevention use of ASA has declined.

PMID:41204227 | DOI:10.1186/s13023-025-04098-0

Crit Care. 2025 Nov 7;29(1):477. doi: 10.1186/s13054-025-05718-8.

ABSTRACT

BACKGROUND: Prolonged mechanical ventilation (MV) frequently results in inspiratory and peripheral muscle weakness, impairing recovery. These conditions can be identified at the bedside using respectively Maximal Inspiratory Pressure (MIP) measurement and Medical Research Council (MRC) score. This study investigated the evolution over the acute-care hospital stay of MIP and MRC score in patients with documented post-extubation inspiratory muscle weakness (IMW), defined as MIP ≤ 30 cmH₂O, and looked for the factors associated with persistent IMW at the end of the acute care hospital stay.

METHOD: This exploratory prospective observational study was conducted across five Swiss hospitals. Patients in the Intensive Care Unit (ICU) who were extubated after ≥ 7 days of MV, with IMW diagnosed within 48 h post planned extubation, were included. Patients’ characteristics and ICU-related factors were recorded throughout the acute care stay as were MIP and MRC score. ICU-acquired weakness (ICU-AW) recorded in the medical file, ICU readmission, reintubation, and hospital mortality were also documented. Descriptive statistics and linear interpolation for missing MIP data were applied, and associations with persistent IMW (MIP ≤ 30 cmH₂O) at study completion were explored using univariable logistic regression. The optimal timepoint for predicting persistent IMW using MIP was identified using a random forest model.

RESULTS: Sixty-nine patients (48 men, 21 women) completed the study. At study completion, persistent IMW was observed in 30 patients (43%), with a median MIP of 22 [13-24] cmH₂O. MIP was of 44 [36-64] in patients without persistent IMW. Persistent IMW was positively associated in univariable logistic regression with female sex, duration of catecholamine use until inclusion, MIP at day 12, MRC score at day 12 and changes in MIP from inclusion to day 12. The presence of respiratory comorbidities was negatively associated with persistent IMW.

CONCLUSION: Persistent IMW following prolonged MV is frequent throughout the acute care stay and until acute care hospital discharge. The MIP measured at day 12 after inclusion, as well as its change from inclusion to day 12, were strongly associated with persistent IMW.

PMID:41204221 | DOI:10.1186/s13054-025-05718-8

Food Chem. 2025 Nov 1;496(Pt 3):146915. doi: 10.1016/j.foodchem.2025.146915. Online ahead of print.

ABSTRACT

Flavor serves as a key quality indicator in tomato puree (TP) processing; however, conventional methods often fall short in providing rapid and accurate assessments. To address this limitation, this study integrated flavoromics with machine learning to characterize sensory transitions and volatile changes during thermal processing and to construct a predictive model for sensory quality. Through HS-SPME-GC-MS analysis, a total of 71 volatile compounds were identified. Corresponding sensory analysis revealed a progressive shift from “Freshness,” “Fruity,” and “Floral” to “Cooked” and “Sourness” as heat intensity increased. Among the five models evaluated, the multilayer perceptron (MLP) demonstrated superior performance (R² > 0.99), effectively capturing nonlinear relationships between volatiles and sensory responses. Variable importance analysis identified ten key volatiles for each sensory descriptor. Moreover, external validation and aroma recombination confirmed the model’s robustness and generalization capacity. These findings offer a practical framework for flavor quality prediction and real-time control in TP production.

PMID:41202367 | DOI:10.1016/j.foodchem.2025.146915

Food Chem. 2025 Nov 5;496(Pt 3):146926. doi: 10.1016/j.foodchem.2025.146926. Online ahead of print.

ABSTRACT

Tea storage is a critical determinant in determining the quality of tea products. This study systematically investigated the quality alterations of instant green tea during storage and developed an intelligent evaluation method by integrating computer vision, electronic nose, and electronic tongue with machine learning. Quantitative chemical profiling established statistically significant correlations between conventional quality indicators and multi-sensor intelligent features. Machine learning models effectively classified the storage duration of instant green tea, with the electronic tongue achieving a classification accuracy exceeding 98 % for storage time prediction. Furthermore, data fusion combined with feature selection algorithms enhanced the predictive accuracy for both storage duration and key quality content. The integration of intelligent sensing technologies provides a robust methodology for rapid shelf-life prediction and quality discrimination of instant tea, establishing a scientific foundation for quality control and authenticity assurance in the tea industry.

PMID:41202358 | DOI:10.1016/j.foodchem.2025.146926

Aging Ment Health. 2025 Nov 7:1-14. doi: 10.1080/13607863.2025.2575025. Online ahead of print.

ABSTRACT

OBJECTIVES: This randomized controlled trial compared flywheel-based resistance training with traditional resistance training on depressive symptoms in sedentary older women.

METHOD: Twenty-nine women aged ≥60 years without clinical depression were randomized (blocks of 2 and 4) to flywheel (n = 14) or traditional resistance training (n = 15) for 8 weeks (six exercises, twice weekly) at the Federal University of Viçosa, Brazil. Flywheel devices provide inertial resistance and eccentric overload by storing and releasing kinetic energy. Depressive symptoms were the primary outcome. Allocation was concealed with sealed envelopes; outcome assessors and the principal investigator were blinded.

RESULTS: Twenty-eight participants completed the protocol; one dropout in the traditional group required multiple imputation. Adjusted depressive symptom scores were 2.7 ± 2.7 in the flywheel group (↓2.5 points) and 2.0 ± 2.8 in the traditional group (↓2.0 points), with no between-group difference (p = 0.193). The effect size was small (ηp² = 0.03) and statistical power was low (1-β = 0.25). All adverse events were mild (grade 1); no serious events occurred.

CONCLUSION: Both flywheel and traditional resistance training showed potential to reduce depressive symptoms in sedentary older women. Larger trials are warranted.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05910632.

PMID:41202328 | DOI:10.1080/13607863.2025.2575025

Am J Speech Lang Pathol. 2025 Nov 7:1-12. doi: 10.1044/2025_AJSLP-25-00036. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to examine the Turkish version of the Short Behavioral Inhibition Scale (SBIS-TR) and to investigate its validity and reliability.

METHOD: The original Short Behavioral Inhibition Scale (SBIS) was translated into Turkish in accordance with the prescribed procedures for the cross-cultural adaptation of self-report measures. This translated version was administered to 227 children and their parents, including children who stutter (CWS) and children who do not stutter (CWNS). After 7-14 days, a random sample of 98 children completed the SBIS again. Reliability and validity were assessed using statistical analyses. Reliability was assessed using Cronbach’s alpha and the test-retest method. Validity was evaluated through confirmatory factor analysis, mean score comparisons between CWS and CWNS, and correlations with the Behavioral Inhibition Questionnaire Parent Form-Turkish version (BIQ-TR) and the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter-Turkish version (KiddyCAT-TR).

RESULTS: SBIS-TR demonstrated high internal consistency, with a Cronbach’s alpha of .86 and a test-retest correlation coefficient of .96. Structural validity analysis confirmed that the single-factor model fits the data well, with all fit indices meeting the accepted thresholds. SBIS-TR scores showed significant negative correlations with BIQ-TR and KiddyCAT-TR scores. No significant difference was found in SBIS-TR scores between CWS and CWNS groups (p = .235), with a median SBIS score of 15 for both groups.

CONCLUSION: The SBIS-TR demonstrated strong reliability and evidence of convergent validity; however, the results did not fully support its construct validity due to the absence of the predicted group differences between CWS and CWNS.

PMID:41202306 | DOI:10.1044/2025_AJSLP-25-00036

JMIR Form Res. 2025 Nov 7;9:e75056. doi: 10.2196/75056.

ABSTRACT

BACKGROUND: The Break Method is a structured, behavior-based emotional reconditioning program designed to help individuals gain insight into patterns of emotional dysregulation and reprogram behavioral responses rooted in past experiences. Although it has been widely adopted in private and small-group settings, empirical evidence supporting its effectiveness remains limited. With increasing interest in accessible, scalable, and personalized mental health interventions, evaluating the outcomes of such programs is essential for informing future implementation and research.

OBJECTIVE: This pilot study aimed to evaluate changes in self-reported mental health status before and after participation in the Break Method program. Specifically, we sought to examine (1) overall trends in mental health improvement, (2) associations between specific reasons for joining the program and changes in mental health outcomes, and (3) latent clusters of participant motivations based on symptom profiles.

METHODS: Data were collected from 175 unique participants, yielding 195 total survey responses (as 15 participants completed the program more than once). Participants rated their mental health status on a 5-point Likert scale both before and after the program (this was not a validated clinical measure, limiting the interpretability and comparability of results). Descriptive statistics and paired 2-tailed t tests were used to assess pre- and postprogram differences in Likert scores. McNemar tests were conducted to compare categorical mental health status (Likert score ≥4 vs <4) before and after participation. Analyses of covariance examined score changes across groups stratified by reported reasons for joining. Multiple correspondence analysis was used to explore latent symptom clusters.

RESULTS: Before program participation, 186 of 195 (95.4%) responses reported Likert scores below 4. Following the program, 157 (80.5%) responses reported scores of 4 or higher. A significant improvement in mental health status was observed (preprogram mean score 2.07 SD 0.82, postprogram mean score 3.92 SD 0.73; P<.001). Significant, positive changes were associated with reasons including anxiety (β=0.332, 95% CI 0.073-0.591), obsessive-compulsive disorder (β=0.455, 95% CI 0.061-0.850), and a history of self-harm or suicidal ideation (β=0.511, 95% CI 0.091-0.931). The multiple correspondence analysis identified three clusters of participants based on symptom profiles: (1) low self-image (eg, depression, self-sabotage, and relationship issues); (2) life-development goals (eg, self-discovery and future planning); and (3) obsessive-compulsive disorder-related symptoms. The first cluster was significantly associated with improved mental health outcomes (β=0.348, 95% CI 0.060-0.636).

CONCLUSIONS: The Break Method appears to be a promising intervention for improving mental health, particularly among individuals reporting anxiety, low confidence, or a history of self-sabotage. However, due to the single-group, preprogram-postprogram design without a control group, causality cannot be inferred, and these findings should be interpreted as preliminary associations rather than confirmed efficacy. Future studies should incorporate standardized clinical tools, control groups, and longitudinal designs to validate these results and explore long-term outcomes across diverse populations.

PMID:41202293 | DOI:10.2196/75056

JMIR Hum Factors. 2025 Nov 7;12:e69305. doi: 10.2196/69305.

ABSTRACT

BACKGROUND: Telepsychiatry has gained considerable attention, particularly during the COVID-19 pandemic. Although various factors influence the choice between online and offline modalities, differences among populations remain underexplored.

OBJECTIVE: This study aims to compare adults seeking mental health support online and offline in private clinics.

METHODS: In this cross-sectional study, we assessed differences in sociodemographic factors, internet accessibility and usability, previous help-seeking history, personality traits assessed using the Arabic Big Five Personality Inventory, and levels of self-stigma measured using the Self-Stigma of Seeking Help Scale.

RESULTS: In total, 259 participants were included (136 online and 123 offline). The online group had a higher proportion of university graduates (P=.02), employed individuals (P<.001), and those with better internet access (P=.03) and higher internet usability (P=.001). The offline group showed higher levels of conscientiousness (P=.003). The primary reasons for choosing online therapy were ease of access and time-saving. Logistic regression identified previous use of online psychiatry as the strongest factor associated with choosing online services (odds ratio [OR] 28.90, 95% CI 11.739-71.165; P<.001). Employment (OR 5.01, 95% CI 1.781-14.080; P=.002), better internet usability (OR 1.69, 95% CI 1.069-2.664; P=.03), and agreeableness (OR 1.16, 95% CI 1.001-1.351; P=.05) were also significant factors. In contrast, previous in-person visits (OR 0.11, 95% CI 0.048-0.269; P<.001), openness (OR 0.85, 95% CI 0.748-0.975; P=.02), and conscientiousness (OR 0.86, 95% CI 0.758-0.971; P=.02) were negatively associated with online preference.

CONCLUSIONS: This study highlights key differences between online and offline mental health help seekers, enhances our understanding of treatment modality preferences, and paves the way for future research.

PMID:41202289 | DOI:10.2196/69305

J Neurosurg Spine. 2025 Nov 7:1-9. doi: 10.3171/2025.6.SPINE25376. Online ahead of print.

ABSTRACT

OBJECTIVE: Paraspinal involvement has been consistently reported as a negative predictor of local control following stereotactic body radiation therapy (SBRT) for spinal metastases. The aim of this study was to investigate the characteristics of paraspinal disease and determine the impact on outcomes.

METHODS: Patients who underwent SBRT for spinal metastases with paraspinal involvement, identified from a single-institutional prospective database, were retrospectively reviewed. Those with prior radiation therapy/surgery were excluded. The treated clinical target volume (CTV) was segmented into paraspinal (CTV_PS), neuroforaminal (CTV_NF), epidural (CTV_EP), and osseous bone (CTV_bone) components. The extent of extraosseous disease was classified according to the involvement of rib, neuroforamina, and muscle. Volume and dosimetric parameters were collected and dichotomized using recursive binary partitioning. The outcomes of interest were the cumulative incidence of local failure (LF), overall survival (OS), and reirradiation rates.

RESULTS: One hundred fourteen patients with 125 treated spinal sites were identified. There were 38% (47/125), 66% (82/125), and 19% (24/125) treated spinal sites with involvement of rib, neuroforamina, and muscle, respectively. The median follow-up duration of the cohort was 17.34 months (IQR 7.79-40.11 months). The 12-month and 24-month cumulative incidence rates of LF were 19.5% (95% CI 12.6%-27.4%) and 29.8% (95% CI 21.4%-38.7%), respectively. The 12-month cumulative incidence rates of LF were 12.0% (95% CI 5.9%-20.5%) and 36.3% (95% CI 20.2%-52.6%) for patients with CTV_PS < 42.9 mL and those with ≥ 42.9 mL (p < 0.001), respectively, and 55.6% (95% CI 28.7%-75.8%) and 12.2% (95% CI 6.5%-19.9%) for patients with and without muscle invasion (p = 0.001), respectively. In the multivariable analysis, only CTV_PS remained statistically associated with LF. CTV_PS ≥ 42.9 mL was associated with 2.3 times (95% CI 1.13-4.83, p = 0.02) increased risk of LF compared with CTV_PS < 42.9 mL. The 12-month and 24-month OS rates were 56% (95% CI 47%-65%) and 41% (95% CI 32%-50%), respectively. Patients with an Eastern Cooperative Oncology Group performance status score < 1 and oligometastatic disease (≤ 5 metastases) were associated with better OS in the multivariable analysis. The 12-month and 24-month reirradiation rates were 7.3% (95% CI 3.4%-13.3%) and 16.5% (95% CI 10.2%-24.1%), respectively.

CONCLUSIONS: Spinal metastases with high-volume paraspinal involvement were associated with increased risk of LF following SBRT, and strategies to optimize local control are required.

PMID:41202272 | DOI:10.3171/2025.6.SPINE25376

J Speech Lang Hear Res. 2025 Nov 7:1-12. doi: 10.1044/2025_JSLHR-25-00336. Online ahead of print.

ABSTRACT

PURPOSE: Intensive comprehensive aphasia programs (ICAPs) are a novel service delivery model incorporating best practice principles in aphasia rehabilitation. Despite increased evidence, adoption of this model into health care services remains limited. This study evaluated the feasibility and effectiveness of the comprehensive, high-dose aphasia treatment (CHAT) program, a modified-ICAP, when implemented by a public rehabilitation facility in Brisbane, Australia.

METHOD: A nonrandomized, Type II hybrid clinical implementation and effectiveness study design was employed. The CHAT program includes 50 hr of goal-directed aphasia rehabilitation, delivered over 8 weeks. Sixty-seven adults with poststroke aphasia consented to the study. Feasibility was evaluated using service statistics (i.e., referrals, adherence, dose) and analyzed using descriptive statistics. Effectiveness evaluated changes in participants’ language impairment, communication activity and participation, and quality of life at posttherapy and 3-month follow-up. Group-level data were analyzed using linear mixed models and Cohen’s d effect sizes. Minimal detectable change (MDC₉₀) was used to determine changes at the individual participant level.

RESULTS: Fourteen cohorts of CHAT were delivered from February 2021 to December 2023. Sixty-five participants completed CHAT, with an average dose of 46.6 hr of therapy. Group-level analyses revealed significant improvements in participants’ language impairment, communication activity and participation, and quality of life (p < .05) at posttherapy and 3-month follow-up. Most participants (89%) demonstrated significant improvements on at least one outcome measure.

CONCLUSIONS: The CHAT program was feasibly delivered within a public, health care context and resulted in positive and enduring changes in participants’ language impairment, communication function, and quality of life.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30522767.

PMID:41202268 | DOI:10.1044/2025_JSLHR-25-00336