Nevin Manimala

Cogn Process. 2025 Apr 5. doi: 10.1007/s10339-025-01265-w. Online ahead of print.

ABSTRACT

Cognitive sex differences are shaped by hormone effects on brain development, organisation, structure, function, and ageing. In human speech and language, sex differences and hormone effects are typically studied in the form of performance-based differences (via measures of central tendency) with little attention given to underlying cognitive strategy. This study presents data from 126 healthy adults, aged 20-79 years, from three studies of letter based verbal fluency. Comparisons were conducted based on sex, menstrual cycle phase, and menopause stage to examine total words produced, plus switching and clustering strategy use. The investigation probed differences in performance, underlying cognitive strategies, and correlations between performance and strategy. For performance, there were no statistically significant sex or menopause group differences in total words, number of switches and cluster size. Menstrual cycle differences were significant for switches and cluster size, but not total words. However, there were large effect sizes for correlations between total word performance and strategy measures in some groups; these correlations formed patterns which differed as a function of sex, menstrual cycle phase, and menopausal stage. Words produced were highly correlated with switching in younger women at higher hormone menstrual cycle phases. Correlations between total words and both strategies were moderate and equivalent in older premenopausal and perimenopausal women. Postmenopausal women showed a pattern of higher correlation between total words and cluster size which was observed in younger women at the lower hormone cycle phase, and men. This study illustrates the impact of hormones and sex differences on strategy use in verbal fluency-underscoring the value of comparisons in strategy use between women at different reproductive life stages.

PMID:40186722 | DOI:10.1007/s10339-025-01265-w

Am J Speech Lang Pathol. 2025 Apr 4:1-37. doi: 10.1044/2025_AJSLP-24-00298. Online ahead of print.

ABSTRACT

PURPOSE: Although approximately 40% of school-based speech-language pathologists (SLPs) regularly serve Deaf and hard of hearing (DHH) students, at present, there are no agreed-upon standards specifying the minimum qualifications and best practices for working with this population, especially those who use signed language. The goal of the present study is to establish expert consensus on recommended clinical training and practice for SLPs working with signing DHH children.

METHOD: Experts in fields related to speech-language pathology and deaf education (N = 30, 16 DHH) participated in three rounds of a classical e-Delphi study. In Round 1, experts responded to open-ended questions about the role of SLPs working with DHH children who sign. In Rounds 2 and 3, experts rated their agreement with statements generated by fellow experts in Round 1.

RESULTS: A mixed-method design included qualitative content analysis (Round 1) and quantitative descriptive statistics (Rounds 2 and 3). Experts rated a total of 185 items in Round 2 and 186 items in Round 3. Consensus (at least 70% agreement) was met for 158 statements, with recommendations for SLPs’ knowledge, attitudes, and practices. Consensus was not achieved for 28 items, including the level of American Sign Language proficiency required for SLPs.

CONCLUSIONS: This study is the first to elicit input from a panel of experts seeking to establish professional standards for SLPs who work with signing DHH children. These findings contribute to the movement toward more inclusive and culturally responsive clinical practice and can inform educational standards and policy for SLPs. Future research is needed to determine whether practicing SLPs meet these recommended standards and how clinical training can support growth for standards that are not currently being met.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28665218.

PMID:40184609 | DOI:10.1044/2025_AJSLP-24-00298

J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 25;9(4). doi: 10.5435/JAAOSGlobal-D-25-00032. eCollection 2025 Apr 1.

ABSTRACT

INTRODUCTION: Surgical treatment of metacarpophalangeal (MCP) joint hyperextension in the treatment of thumb basal joint arthritis can be categorized as motion preserving and arthrodesis. We compared minimum 2-year results between nonsurgical thumbs and thumbs undergoing ligament reconstruction with tendon interposition (LRTI) alone, thumb MCP arthrodesis, and volar plate capsulodesis as adjunct procedures to LRTI.

METHODS: Single surgeon patients with thumb MCP hyperextension >30° underwent arthrodesis or volar plate capsulodesis with LRTI. Thirty-one LRTI thumbs were compared with 22 LRTI with arthrodesis (LRTI + A), 21 LRTI with MCP capsulodesis (LRTI + C), and 65 nonsurgical controls. Patient-reported outcome measures were recorded with grip strength, tip pinch, lateral pinch, opposition, and pre-/postoperative hyperextension measured by one of the authors.

RESULTS: No difference was found in Michigan Hand Questionnaire scores (P = 0.13), QuickDASH values (P = 0.38), or visual analog scale results (P = 0.86). No difference was observed in grip strength (P = 0.97) or tip pinch (P = 0.66). Lateral pinch was decreased between LRTI and nonsurgical thumbs but not when compared with groups with adjunct MCP procedures (P = 0.0064). LRTI + A had the least opposition (P < 0.001). In the LRTI + C group, MCP hyperextension worsened in two patients (9%) and 14 of 22 (63%) had postoperative values equal or greater than 30°.

DISCUSSION AND CONCLUSION: Our LRTI + C cohort experienced persistent MCP hyperextension, with mean postoperative hyperextension of >30°. Despite the literature suggesting that this portends inferior outcomes, our LRTI + C cohort demonstrated near-equal outcomes when compared with the LRTI, LRTI + A, and control groups. We no longer perform capsulodesis for MCP hyperextension and offer arthrodesis for MCP arthrosis or hyperextension not actively correctable by the patient.

PMID:40184604 | DOI:10.5435/JAAOSGlobal-D-25-00032

Neurology. 2025 May 13;104(9):e213560. doi: 10.1212/WNL.0000000000213560. Epub 2025 Apr 4.

ABSTRACT

BACKGROUND AND OBJECTIVES: Poor long-term blood pressure (BP) control due to undertreatment of hypertension is not uncommon after intracerebral hemorrhage (ICH). It heightens the risk of ICH recurrence and subsequent stroke, which is the highest within the first year. Promptly achieving BP targets would significantly reduce these risks. To accomplish this, upfront triple antihypertensive medications could be prescribed soon after ICH because many ICH survivors require ≥3 antihypertensives. However, not all would suit this approach, particularly those with cerebral amyloid angiopathy (CAA), where elevated admission BP may be due to acute hypertensive response rather than underlying hypertension. In addition, overtreatment and excessive BP lowering would cause more side effects and have been associated with increased mortality in older patients. Hence, to facilitate individualized treatment, we aimed to develop a score (TRICH) to predict the need for ≥3 antihypertensives at 3 months after ICH.

METHODS: We developed the score using data from the University of Hong Kong prospective ICH registry (2011-2022) and validated it in 3 hospitals (2020-2022) locally. Consecutive patients with spontaneous ICH who survived >90 days and had follow-up BP 3 months after ICH were included. Predictors for needing ≥3 antihypertensive medications at 3 months were identified using multivariate logistic regression, and the score was created using the β-coefficients.

RESULTS: The TRICH score was developed from 462 patients (mean age 66.6 ± 14.3 years, 60% male) and validated in 203 patients (mean age 66.3 ± 14.6 years, 62% male). The 9-point score (age younger than 60 years = 1, male = 1, ischemic heart disease = 1, admission estimated glomerular filtration rate <60 mL/min/1.73 m² = 2, admission systolic BP 190-230 mm Hg = 2 while >230 mm Hg = 4) has a c-statistic (95% CI) of 0.79 (0.75-0.83) in the development cohort and 0.76 (0.69-0.82) in validation. A dichotomized score (≥3 points) predicted the need for ≥3 antihypertensives with 0.73 (95% CI 0.67-0.80) sensitivity and 0.76 (95% CI 0.70-0.81) specificity. The score performed better in patients with untreated/uncontrolled hypertension before ICH than in controlled patients (c-statistic [95% CI] 0.81 [0.77-0.86] vs 0.74 [0.69-0.80], p = 0.037) but showed no difference between patients with CAA and non-CAA patients.

DISCUSSION: The TRICH score identifies patients with ICH who need ≥3 antihypertensive medications 3 months after ICH with good discrimination ability. It may guide upfront triple antihypertensive prescription, but further research is warranted, particularly in non-Han Chinese populations.

PMID:40184593 | DOI:10.1212/WNL.0000000000213560

Retina. 2025 Apr 2. doi: 10.1097/IAE.0000000000004477. Online ahead of print.

ABSTRACT

PURPOSE: To report the 5-year outcomes of intravitreal aflibercept in patients with macular edema due to central retinal vein occlusion(CRVO).

METHODS: Participants in this study were 51 treatment naïve patients with macular edema due to CRVO, who received intravitreal aflibercept 2.0mg using a treat-and-extend regimen after a loading dose of three-monthly injections. The primary outcomes were the mean change in best-corrected visual acuity(BCVA) and central subfield thickness(CST) at month 60 compared to baseline.

RESULTS: At month 60, there was a statistically significant improvement in BCVA with a mean change of 11.5 letters compared to baseline(p<0.001). 19.6% of patients gained ≥15 ETDRS letters compared to baseline. Accordingly, at month 60, there was a statistically significant reduction in CST of about 195 μm compared to baseline(p<0.001). The mean number of injections at month 60 was 23.7. At month 60, about 50% of patients were found to have “good” treatment response, which was associated with ellipsoid zone integrity and the absence of hyperreflective foci on optical coherence tomography. It is worthy to note that 60.8% of patients achieved treatment interval of ≥8 weeks, while 31.4% of patients ≥12 weeks. Factors associated with an extended treatment interval was intact ellipsoid zone, lower baseline CST and the absence of disorganization of inner retinal layers.

CONCLUSIONS: At the 5-year follow-up, intravitreal aflibercept showed a mean gain of 11.5 letters in BCVA with an average of 23.7 injections. 31.4% of patients achieved a treatment interval of ≥12 weeks, while about half of patients showed good treatment response.

PMID:40184581 | DOI:10.1097/IAE.0000000000004477

JCO Glob Oncol. 2025 Apr;11:e2400212. doi: 10.1200/GO.24.00212. Epub 2025 Apr 4.

ABSTRACT

PURPOSE: Although lung cancer is a major cause of cancer incidence and mortality worldwide, lung cancer studies in sub-Saharan Africa are scarce. Here, we present outputs from a designated lung cancer program in western Kenya, part of the Multi-National Lung Cancer Control Program, which focused on case finding, diagnosis, and treatment.

METHODS: We retrospectively reviewed patients with pathologically confirmed non-small cell lung cancer (NSCLC) enrolled in this program at Moi Teaching and Referral Hospital from January 2018 to December 2022. Clinical data were analyzed using descriptive statistics, Kaplan-Meier methods, and proportional hazards regression model.

RESULTS: Two hundred forty-nine patients diagnosed with NSCLC were included with a median age at diagnosis of 61 (IQR, 52-70) years. Most patients were married (n = 177; 71%) and nonsmokers (n = 177; 71%) with 58 (23%) having received tuberculosis treatment and 93 (37%) having Eastern Cooperative Oncology Group (ECOG) performance status (PS) of $\ge$2. At diagnosis, adenocarcinoma was the prominent histology (n = 187; 75%) along with clinical stage IV (n = 195; 78% stage IV) or unstaged (n = 40; 16%) disease. Most patients received chemotherapy and radiotherapy (n = 176; 71%) with few palliative care referrals (n = 2; 0.8%). The median overall survival (OS) was only 3.7 months (IQR, 2.7-5.4). ECOG PS (3 or 4) and being unstaged were predictors of poor 1-year OS.

CONCLUSION: Patients with NSCLC enrolled in this program presented with advanced disease and poor survival. Despite a designated case finding effort, late diagnosis remained common and highlights a need for locally relevant interventions targeting community and provider education as well as innovative diagnostics that can improve early recognition of lung cancer. These interventions must also be paired with access to proven treatments including molecular therapies and palliative care which can extend lung cancer survival.

PMID:40184569 | DOI:10.1200/GO.24.00212

JCO Glob Oncol. 2025 Apr;11:e2400543. doi: 10.1200/GO-24-00543. Epub 2025 Apr 4.

ABSTRACT

PURPOSE: Sub-Saharan Africa carries one of the highest burdens of hepatocellular carcinoma (HCC) in the world, with hepatitis B virus (HBV) as the most common cause. Studies in several regions of the world suggest important cancer differences in rural versus urban settings, but limited studies have been performed in Africa.

METHODS: We performed a scoping review and pooled analysis of studies on HCC in Africa. Using land use data from the European Space Agency, we calculated the distance in kilometers from each study site to the nearest rural area. Regression models were fit to estimate the association between distance to the nearest rural area and HBV, sex, and weighted mean age.

RESULTS: Data from 57 studies including 10,907 patients across 36 towns/cities were included in our analysis. Proximity to rural areas was associated with a higher frequency of HBV-associated HCC in assessment of distance both at midpoint and at quartiles after controlling for country: risk ratio (RR) 1.71 (95% CI, 1.52 to 1.93) and RR 1.51 (95% CI, 1.25 to 1.84), respectively. No association was found between sex and proximity to a rural area: RR 1.02 (95% CI, 0.96 to 1.08). The weighted mean age across the four distance quartiles was 50.09, 53.43, 47.98, and 53.35 years with no statistically significant difference found across the quartiles (P = .81).

CONCLUSION: Individuals living in rural Africa have a higher rate of HBV-related HCC compared with other liver diseases. Increased HBV awareness efforts in these areas should be considered.

PMID:40184566 | DOI:10.1200/GO-24-00543

PLoS Comput Biol. 2025 Apr 4;21(4):e1012904. doi: 10.1371/journal.pcbi.1012904. eCollection 2025 Apr.

ABSTRACT

Cell type annotation is crucial in single-cell RNA sequencing data analysis because it enables significant biological discoveries and deepens our understanding of tissue biology. Given the high-dimensional and highly sparse nature of single-cell RNA sequencing data, most existing annotation tools focus on highly variable genes to reduce dimensionality and computational load. However, this approach inevitably results in information loss, potentially weakening the model’s generalization performance and adaptability to novel datasets. To mitigate this issue, we developed scTrans, a single cell Transformer-based model, which employs sparse attention to utilize all non-zero genes, thereby effectively reducing the input data dimensionality while minimizing information loss. We validated the speed and accuracy of scTrans by performing cell type annotation on 31 different tissues within the Mouse Cell Atlas. Remarkably, even with datasets nearing a million cells, scTrans efficiently perform cell type annotation in limited computational resources. Furthermore, scTrans demonstrates strong generalization capabilities, accurately annotating cells in novel datasets and generating high-quality latent representations, which are essential for precise clustering and trajectory analysis.

PMID:40184563 | DOI:10.1371/journal.pcbi.1012904

PLoS Comput Biol. 2025 Apr 4;21(4):e1012906. doi: 10.1371/journal.pcbi.1012906. eCollection 2025 Apr.

ABSTRACT

Contact tracing is an important public health measure used to reduce transmission of infectious diseases. Contact tracers typically conduct telephone interviews with cases to identify contacts and direct them to quarantine, with the aim of preventing onward transmission. However, in situations where caseloads exceed the capacity of the public health system, timely interviews may not be feasible for all cases. Here we present a modelling framework for assessing the impact of different case interview prioritisation strategies on disease transmission. Our model is based on Australian contact tracing procedures and informed by contact tracing data on COVID-19 cases notified in Australia from 2020 to 2021. Our results demonstrate that last-in-first-out strategies (where cases with the most recent swab or notification dates are interviewed first) are more effective at reducing transmission than first-in-first-out strategies (where cases with the oldest swab or notification dates are interviewed first) or strategies with no explicit prioritisation. To maximise the public health benefit from a given case interview capacity, public health practitioners may consider our findings when designing case interview prioritisation protocols for outbreak response.

PMID:40184558 | DOI:10.1371/journal.pcbi.1012906