Nevin Manimala

Int J Lang Commun Disord. 2026 Mar-Apr;61(2):e70214. doi: 10.1111/1460-6984.70214.

ABSTRACT

BACKGROUND: Speech and language therapists (SLTs) working in dysphagia care regularly navigate complex ethical dilemmas involving clinical risk, patient autonomy and cultural considerations. While ethical principles are well-recognized in the field, consolidated evidence mapping how these principles and ethical reasoning components have been represented in the literature over time remains limited. This review offers a comprehensive synthesis of ethical challenges in dysphagia management across decades and contexts, uniquely structured using Rest’s Four-Component Model of ethical behaviour.

METHOD: This scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. A systematic search of databases from 1990 to 2024 identified 22 peer-reviewed articles. Data were analysed using descriptive statistics and thematic content analysis, with ethical principles and components classified according to Beauchamp and Childress and Rest’s Four-Component Model.

MAIN CONTRIBUTIONS: Analysis revealed evolving ethical priorities within interdisciplinary roles and responsibilities of SLTs. These ethical priorities suggest the importance of ethical decision- making and person-centred care in dysphagia management, specifically foregrounded by the focus on the principles of autonomy and informed consent and the components of moral judgement and sensitivity.

CONCLUSION: The findings underscore the dynamic and complex ethical landscape of dysphagia management, emphasizing the need for cultural awareness and respect, shared decision-making and evidence-based practice. To navigate these challenges, SLTs require continuous education, interdisciplinary collaboration and adaptable ethical frameworks. This review provides a comprehensive synthesis of ethical challenges and considerations through longitudinal, theory-informed analyses using Rest’s Four Component model. This model is useful in breaking down complexity into understandable psychological steps, identifying gaps, guiding education and culture by fostering genuine ethical conduct beyond intellectual understanding across decades, geographic regions and professional roles in SLT.

WHAT THIS PAPER ADDS: What is already known on this subject The field of dysphagia often places SLTs at the intersection of clinical care, patient preferences and ethical decision-making, making the consideration of ethical principles an integral part of their practice. What this paper adds to existing knowledge A comprehensive synthesis of ethical challenges and considerations in dysphagia spanning multiple decades, geographic regions and methodological approaches using Rest’s Four-Component Model to classify ethical components. What are the potential or actual clinical implications of this work? Cultural awareness and shared decision making are vital aspects in dysphagia management, with the use of telepractice raising ethical concerns related to equity, privacy and informed consent.

PMID:41758432 | DOI:10.1111/1460-6984.70214

AIDS Behav. 2026 Feb 27. doi: 10.1007/s10461-026-05083-9. Online ahead of print.

ABSTRACT

In 2022, over two thirds of individuals diagnosed with HIV in the United States were people of color, half resided in the south, and 67% of new cases were attributed to male-to male sexual transmission (Centers For Disease Control, 2024). To combat these health disparities, the Ending the HIV Epidemic (EHE) initiative recommends that HIV prevention research focus on targeted populations and geographic regions with high rates of new HIV diagnosis. There are limited data on the relative efficiency of social media and dating apps for the recruitment of key EHE populations to HIV prevention studies. The LITE-2 Study aimed to recruit a national sample of approximately 3,000 young men who have sex with men (YMSM), at least 30% Black/African American and 30% Hispanic/Latino. This analysis compared the success of different social media platforms in relation to study goals, using descriptive statistics from the LITE-2 study (N = 2999) to assess enrollment count, eligibility rates, cost, and geographic distribution for each platform. Facebook had the highest enrollment rate, 45.38%, among eligible screeners. The cost per enrolled participant for Grindr, Sniffies, Scruff, Jack’d, and Adam4Adam was $118.02, $129.46, $220.59, $252.53, and $305.56 respectively. Jack’d had the highest proportion of Black participants, and Sniffies the highest proportion of Hispanic/Latino individuals. Use of Scruff resulted in enrollment of the highest proportion of participants in the rural EHE jurisdictions (47.1%). These findings inform digital recruitment strategies for future studies with similar racial/ethnic and geographic targets.

PMID:41758405 | DOI:10.1007/s10461-026-05083-9

Arch Orthop Trauma Surg. 2026 Feb 27;146(1):91. doi: 10.1007/s00402-026-06207-5.

ABSTRACT

BACKGROUND: Primary vascular bone tumors are rare, spanning from benign to highly malignant lesions. Pelvic and extremity involvement is uncommon, and differentiation between benign and malignant tumors remains challenging due to overlapping radiological and pathological features. This study aimed to identify imaging predictors of malignancy and evaluate clinical outcomes in vascular bone tumors of the pelvis and extremities.

METHODS: We retrospectively analyzed 18 patients diagnosed with vascular bone tumors between 2013 and 2024. Tumors were classified as benign (hemangioma, epithelioid hemangioma; n = 11) or malignant (angiosarcoma, epithelioid hemangioendothelioma; n = 7). Demographic, radiological (plain radiographs, MRI, CT), and clinical data were collected. Cortical expansion/destruction, pathological fractures, soft tissue components, and tumor size were assessed. Statistical analysis included Fisher’s exact test, Mann-Whitney U test, Spearman correlation, and ROC analysis to identify predictors of malignancy.

RESULTS: Median age was 41.0 years for benign and 53.0 years for malignant tumors. Soft tissue components were significantly more frequent in malignant tumors (57% vs. 9%, p = 0.025), and tumor size was larger (mean 9.0 cm vs. 3.7 cm, p = 0.001). Cortical expansion, destruction, and pathological fractures did not differ significantly. ROC analysis suggested that larger tumor size (≥ 5.5 cm in this cohort) was associated with malignancy with 85.7% sensitivity and 90.9% specificity (AUC = 0.929, p = 0.003) and should be interpreted as an exploratory finding. All benign tumors underwent intralesional curettage, with no recurrences or complications observed. In contrast, malignant tumors exhibited high rates of relapse and mortality, with only one patient with epithelioid hemangioendothelioma surviving with stable disease at 112 months.

CONCLUSION: In vascular bone tumors of the pelvis and extremities, the presence of a soft tissue component and tumor size ≥ 5.5 cm are among the most useful radiological features associated with malignancy. While benign lesions generally have excellent outcomes with curettage, malignant tumors are associated with a poor prognosis. Histopathological confirmation remains essential, and larger series are needed to refine diagnostic and prognostic criteria.

PMID:41758394 | DOI:10.1007/s00402-026-06207-5

Int Urogynecol J. 2026 Feb 27. doi: 10.1007/s00192-026-06523-9. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: High impact physical activity (PA) in sportswomen is a risk factor for the development of stress-induced urinary incontinence and potentially for other dysfunctions of the pelvic floor. This study was aimed at assessing the occurrence of lower urinary tract symptoms (LUTS) in professional female judo practitioners.

METHODS: This observational, cross-sectional study included a total of 88 women practising professional judo and 88 women practising other sports disciplines. Participants completed Core Lower Urinary Tract Symptom Score (CLSS) questionnaire to assess the condition of the lower urinary tract, along with sport-related data questionnaires and self-reported anthropometric measures.

RESULTS: Among 19.31% of women practising judo no LUTS were recorded and the majority of the remaining judo athletes (67.6%) indicated the occurrence of one or two symptoms. Urgency was the most common symptom (40.9%). Six of the 10 analysed LUTS were statistically significantly less frequent in female judo athletes and the average number of LUTS was statistically significantly lower in this group (95% CI 1.67-2.48 vs 2.9-3.94; p < 0.001). Severity of three symptoms (nocturia, incomplete emptying of the bladder and urethral pain) was statistically significantly lower in women practising judo and their overall CLSS score was statistically significantly lower (95% CI 1.96-3.1 vs 3.9-5.68; p < 0.001). These athletes were also more satisfied with the level of acceptance of the CLSS condition (95% CI 0.67-1.18 vs 1.19-1.84; p < 0.01).

CONCLUSIONS: Compared to other disciplines, competitive judo is not a risk factor for increased LUTS; therefore, the level of health satisfaction with the condition of the lower urinary tract in women practising judo is high.

PMID:41758386 | DOI:10.1007/s00192-026-06523-9

J Low Genit Tract Dis. 2026 Feb 27. doi: 10.1097/LGT.0000000000000938. Online ahead of print.

ABSTRACT

OBJECTIVE: We evaluated the adherence of cervical cancer screening (CCS) to ASCCP guidelines in the United States within a single hybrid community-academic institution.

METHODS: In this retrospective cohort study, pap smears from October 2022 through December 2023 were abstracted from the electronic medical record. Adherence with CCS was determined by collecting tests ordered, the interval between tests, and subsequent result management. The findings were classified as adherent (appropriate order, interval, and management) or nonadherent. Descriptive statistics were employed.

RESULTS: Three hundred and forty-eight pap smears were included; 225 (65%) were normal and 123 (35%) were abnormal. Two hundred thirty-two (67%) were nonadherent with ASCCP guidelines, while 116 (33%) were adherent. Of the nonadherent pap smears, 71 (31%) were ordered incorrectly, most commonly due to lack of HPV cotesting (87%); 190 (55%) were performed at an incorrect interval, most commonly due to an inappropriately short interval (89%); and 63 (18%) were managed inappropriately, most commonly due to lack of indicated colposcopy (57%) or unnecessary colposcopy (33%). Based on specific cytology results, overall adherence, appropriateness of interval, and order type did not vary between results (p=.18, p=.71, p=.23, respectively); however, the subsequent management was significantly different based on the cytology (p<.001). There were significant differences among provider type (p=.01) and practice (p<.001), but no difference by age, BMI, or medical comorbidity.

CONCLUSIONS: In this cohort, the majority of pap smears were nonadherent, largely due to underutilization of HPV cotesting, overscreening, and lack of indicated colposcopy. With clear guidelines available, there is significant room for improvement.

PMID:41758382 | DOI:10.1097/LGT.0000000000000938

Naunyn Schmiedebergs Arch Pharmacol. 2026 Feb 27. doi: 10.1007/s00210-026-05092-4. Online ahead of print.

ABSTRACT

This study aims to evaluate the post-marketing safety profile of voretigene neparvovec using a large spontaneous reporting database. This is a. retrospective pharmacovigilance disproportionality study. Adverse event (AE) reports for voretigene neparvovec were retrieved from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS), Q1 2019-Q1 2025. Disproportionality was assessed using reporting odds ratio (ROR), proportional reporting ratio (PRR), information component (IC), and empirical Bayesian geometric mean (EBGM). Signals were summarized at the System Organ Class (SOC) and Preferred Term (PT) levels. A total of 128 AE reports were included. The median patient age was 18 years, with adolescents and young adults comprising the majority. The primary sources of reports were physicians (44.53%) and consumers (43.75%), with intraocular injection being the most frequently reported route of administration (25.00%). Signal analysis revealed that ocular disorders had the highest number of reports and the most prominent signal strength (e.g., retinal degeneration: ROR = 3742.02, IC025 = 6.93; retinal depigmentation: ROR = 8865.67, IC025 = 8.37). Other significant signals included vitreous floaters (ROR = 1497.43, IC025 = 5.43) and elevated intraocular pressure (ROR = 473.10, IC025 = 4.37). In contrast, systemic events such as headache and ocular pain showed weaker signals that did not exceed the statistical significance threshold. In real-world use, voretigene neparvovec is mainly associated with ocular AEs linked to surgical delivery and local inflammatory responses, notably structural retinal changes and intraocular pressure elevations. These findings support careful preoperative assessment, optimized perioperative technique, and close postoperative monitoring. FAERS-based signals indicate association rather than causality and should be interpreted alongside prospective data. Clinical trial number is not applicable.

PMID:41758347 | DOI:10.1007/s00210-026-05092-4

Naunyn Schmiedebergs Arch Pharmacol. 2026 Feb 27. doi: 10.1007/s00210-026-05148-5. Online ahead of print.

ABSTRACT

Trabectedin has been approved for treating adult patients with unresectable or metastatic liposarcoma or leiomyosarcoma who have previously received anthracycline. However, the long-term safety of trabectedin in a large-sample population remains unknown. We used a real-world pharmacovigilance database to assess adverse events (AEs) related to trabectedin. A disproportionality analysis was performed to evaluate the relationship between trabectedin and AEs. Data between January 2015 and March 2024 were collected from the United States Food and Drug Administration Adverse Event Reporting System (FAERS), an international pharmacovigilance database, to analyze the characteristics and onset time of trabectedin-related AEs. During the studied period, the FAERS database recorded 14,931,458 AE reports, of which 1,748 were related to trabectedin. Approximately 137 trabectedin-related AE signals were identified in 17 system organ classes. The most common AEs listed on the trabectedin label were neutropenia, anemia, thrombocytopenia, and hepatobiliary disorders. We identified twenty-four new and unexpected significant off-label AEs, including atrial flutter, supraventricular tachycardia, increased troponin, venous thromboembolism, hyponatremia, hypokalemia, hypocalcemia, and hypophosphatemia. The median onset time of trabectedin-related AEs was 18.5 (interquartile range, 5-55.25) days. The findings confirmed expected trabectedin-related AEs and identified new AEs.

PMID:41758346 | DOI:10.1007/s00210-026-05148-5

Eur Radiol. 2026 Feb 27. doi: 10.1007/s00330-026-12360-7. Online ahead of print.

NO ABSTRACT

PMID:41758345 | DOI:10.1007/s00330-026-12360-7

Eur Radiol. 2026 Feb 27. doi: 10.1007/s00330-026-12411-z. Online ahead of print.

NO ABSTRACT

PMID:41758344 | DOI:10.1007/s00330-026-12411-z

Eur Radiol. 2026 Feb 27. doi: 10.1007/s00330-025-12302-9. Online ahead of print.

ABSTRACT

OBJECTIVES: Assessing regional brain atrophy on 3D-T1w imaging is crucial for evaluating neurodegenerative disorders. However, high-quality volumetric imaging is not always available. Thus, AI-based algorithms were developed to generate “synthetic” 3D-T1w sequences using various clinical sequences as input. This retrospective study aims to investigate whether regional atrophy patterns are preserved in deep learning-based synthetic 3D-T1w sequences from different inputs.

MATERIALS AND METHODS: The study included patients with Alzheimer’s disease (AD), Frontotemporal dementia (FTD), and healthy controls (HC). Probands were scanned at 3 T, and deep learning-based synthetic 3D-T1w images were generated from various inputs (3D FLAIR, 4 mm axial FLAIR, 4 mm coronal T2) using FreeSurfer-based SynthSR. Real 3D-T1w images served as the reference standard. Brain volumetry was performed using SynthSeg+ in FreeSurfer and the AssemblyNet-AD-FTD pipeline in VolBrain.

RESULTS: Global and regional volumes differed significantly between deep learning-based synthetized sequences and the reference standard 3D T1 for all subgroups and inputs (total white matter volume AD p = 0.0002, FTD p < 0.0001, HC p = 0.0116; total gray matter volume for AD, FTD, and HC p < 0.0001), except for hippocampal volumes. This systematic error in overestimating volumes affected automated disease probability prediction in FTD for all inputs (p < 0.0001) and in HC for coronal T2 input (adj. p = 0.0054).

CONCLUSION: Deep learning-based synthetic 3D-T1w sequences introduce systematic errors in assessing global and regional brain volumetric measures, leading to overestimated volumes in controls and patients. Resulting synthetic images should be used cautiously, especially for volumetric analyses.

KEY POINTS: Question It remains unclear whether deep learning-based synthetic 3D-T1w images from various inputs preserve regional atrophy patterns sufficiently to serve as input for automated volumetry. Findings Deep learning-based synthetic T1w images overestimate regional and global brain volumes in neurodegenerative diseases and controls, increasing with lower quality inputs. Clinical relevance Deep learning-based synthetic images should only be used with caution for volumetric evaluation of brain MRI scans. If possible, 3D scans should be used as input.

PMID:41758343 | DOI:10.1007/s00330-025-12302-9