Nevin Manimala

J Voice. 2025 Sep 5:S0892-1997(25)00299-1. doi: 10.1016/j.jvoice.2025.07.036. Online ahead of print.

ABSTRACT

To this day, the assessment of human voices remains a challenge due to (i) inconsistencies in subjective ratings and (ii) the lack of objective measurements for the perceptual impressions of voice characteristics. This can lead to significant consequences in applied fields such as speech therapy, where the assessment of voices is crucial for a successful treatment. In this paper, we address the explanation of voice and its characteristics from two different angles: In a first study, 22 speech therapists in training assessed a set of 20 non-pathological voices regarding 20 voice characteristics before and after receiving an expert explanation. Although the expert explanation did not lead to an improvement in overall rating performance, the analysis still yielded valuable insights into the particular challenges for novice voice practitioners in their characterization of voices. A second study aimed at a better understanding of the link between perceived voice characteristics and acoustic features. A data set of 295 voice samples of the same corpus was labeled by an expert with regard to the same 20 voice characteristics as in the first study. Afterwards, we analyzed the speech samples using a set of acoustic features, which were then used as predictors in statistical models of the annotated characteristics. This analysis yielded a unique set of significant acoustic features as main effects predicting each individual voice characteristic, although the model fits were overall modest. Furthermore, all of the voice characteristic models showed interactions with the speakers’ gender. These results suggest a necessity for paying special attention to gender differences when assessing voice. Interestingly, we obtained a tendency for a higher model accuracy for those voice characteristics that have also shown to be rated more accurately and consistently by human listeners.

PMID:40914724 | DOI:10.1016/j.jvoice.2025.07.036

Pain Manag Nurs. 2025 Sep 5:S1524-9042(25)00243-7. doi: 10.1016/j.pmn.2025.08.001. Online ahead of print.

ABSTRACT

PURPOSE: To compare the effects of cervical stabilization exercise training via telerehabilitation (CSET-T) in addition to standard treatment on pain, forward head posture, cervical mobility, muscle performance, functional status, sleep quality, and quality of life in individuals with migraine in comparison to the standard treatment alone.

METHODS: The control group (n = 20) received standard treatment alone (medication+recommendations). The stabilization group (n = 20) was given CSET-T in addition to standard treatment 3 days a week for 8 weeks. Pain characteristics were assessed by using a pain diary, whereas forward head posture and cervical mobility were measured using a goniometer, cervical muscle performance (CMP) by using a pressure biofeedback unit, functional status by using the Migraine Disability Assessment Scale (MIDAS), sleep quality by using the Jenkins Sleep Scale (JSS), and quality of life by using the Headache Impact Test-6 (HIT-6).

RESULTS: Given the group-time interaction, it was found that pain frequency, intensity, duration, MIDAS, JSS, and HIT-6 scores decreased more significantly in the stabilization group when compared to the control group (p < .05). Moreover, the craniovertebral angle, cervical range of motions, and CMP values increased significantly more in the stabilization group (p < .05). It was found that there was no statistically significant difference between the groups in terms of compliance with standard treatment (p = .665).

CONCLUSIONS: The study revealed that CSET-T in addition to standard treatment is superior to standard treatment alone in reducing pain, improving forward head posture, cervical mobility, muscle performance, functional status, and quality of life in individuals with migraine.

PMID:40914685 | DOI:10.1016/j.pmn.2025.08.001

J Orthop Sci. 2025 Sep 5:S0949-2658(25)00262-3. doi: 10.1016/j.jos.2025.08.006. Online ahead of print.

ABSTRACT

BACKGROUND: The Stoppa approach was modified to manage fractures of the anterior column as an alternative to the ilioinguinal approach to reduce complications. A debate persists regarding the superiority of one approach over the other. Therefore, in the present study we performed a randomized controlled trial (RCT) to investigate the following hypotheses: (1) Whether the modified Stoppa approach leads to reduced blood loss, (2) Whether the functional and radiological outcomes with the modified Stoppa approach are superior to those with the ilioinguinal approach, and (3) Whether the complication rates differ between the two approaches.

METHODS: A total of 92 patients were initially enrolled in the study. After applying exclusion criteria and obtaining informed consent, 60 patients with acetabular fractures were randomly allocated into two groups and underwent internal fixation at our tertiary care hospital using either the ilioinguinal approach or the modified Stoppa approach. Bleeding and surgical time was evaluated intraoperatively. Post-operative evaluation of wound drainage and neurovascular status was done. Post-operative radiographs reduction assessment of reduction was done as per Matta scoring and clinically Merle D’Aubigne score was compared at 12 months. All data were statistically analyzed with non-parametric tests by using SPSS 20.0 software.

RESULTS: Among the studied population, 48.3 % cases (21.6 % and 26.7 % with ilioinguinal and modified Stoppa approach, respectively) of all patients exhibited excellent radiological outcomes. Additionally, 33.3 % (15 % with the ilioinguinal approach and 18.3 % with the modified Stoppa approach) achieved an excellent clinical score based on the Merle D’Aubigne criteria at 12 months. However, no significant difference was found between two approaches. Both the approaches offer adequate exposure however; quadrilateral surface is directly visualised with the modified Stoppa approach. Considering two significant findings, i.e., reduced intra-operative blood loss and shorter surgical duration was associated with the modified Stoppa approach.

CONCLUSION: Notably, in the context of the ongoing debate between proponents of these two approaches, our study presents a valuable contribution. Overall, the modified Stoppa approach is a better choice in treating anterior acetabular fractures.

PMID:40914680 | DOI:10.1016/j.jos.2025.08.006

Rev Infirm. 2025 Aug-Sep;74(313):14-15. doi: 10.1016/j.revinf.2025.07.005. Epub 2025 Aug 11.

ABSTRACT

Functional neurological disorders are characterized by a variety of neurological symptoms that are not explained by an identifiable organic pathology. Despite their significant prevalence and major impact on quality of life, their recognition and management remain inadequate. Formerly known as hysteria, modern criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition [DSM-5]) allow a positive diagnosis, distinct from malingering. These disorders often lead to long periods of misdiagnosis, high levels of care consumption and significant socio-economic repercussions, including frequent loss of employment. Improving the training of professionals, developing specific treatments, reducing stigmatization and providing support for patients are crucial to meeting this public health challenge.

PMID:40914611 | DOI:10.1016/j.revinf.2025.07.005

Int J Radiat Oncol Biol Phys. 2025 Sep 4:S0360-3016(25)06201-7. doi: 10.1016/j.ijrobp.2025.08.053. Online ahead of print.

ABSTRACT

PURPOSE: This study examined head and neck cancer treatment outcome priorities in patients with human papillomavirus-associated oropharyngeal cancer (HPVOPC) before and 12 months (12m) after (chemo)radiotherapy ([C]RT).

METHODS AND MATERIALS: Eligible patients were diagnosed with HPVOPC suitable for curative-intent primary [C]RT. Study data included responses to a modified version of the Chicago Priorities Scale (CPS-modified) and select items from the MDASI Head and Neck Cancer Module (MDASI-HN). Analysis included descriptive statistics, McNemar’s test for binary matched-pairs and general linear models.

RESULTS: The CPS-modified was completed by 99 patients before [C]RT, 91 12m after [C]RT and 90 at both assessments. Treatment outcomes classified as top priorities were comparable before and 12m after [C]RT: ‘being cured of my cancer’ (cure, 93%/91%), ‘living as long as possible’ (survival, 69%/66%), ‘being able to swallow all foods and drinks’ (swallow, 56%/56%), ‘having a normal amount of energy’ (energy, 51%/48%) and ‘having no pain’ (pain, 51%/48%). After [C]RT, cure and survival were ranked highest (1 of 13) by 65/90 (72%) and 12/90 (13%) patients, respectively, and swallow was ranked above cure, survival, pain, energy, ‘keeping my normal sense of taste and smell’ (senses) and ‘having a comfortably moist mouth’ (moist mouth) by 14%, 36%, 47%, 55%, 56% and 66% of patients, respectively. More patients identified senses and moist mouth as a top priority 12m after [C]RT than before [C]RT (26%/44%, p=0.002; and 19%/39%, p=0.003, respectively). Select MDASI-HN symptom severity scores did not differ by CPS-modified priority groupings (top versus middle/lower) 12m after [C]RT (all p>0.05).

CONCLUSIONS: For HPVOPC patients, the most important treatment outcome priorities are stable before and 12m after [C]RT. After C[RT], only 56% of HPVOPC survivors considered swallowing a top priority. Patient priorities should be considered when designing future de-escalation treatment strategies, considering the excellent outcomes with standard treatment.

PMID:40914539 | DOI:10.1016/j.ijrobp.2025.08.053

J Affect Disord. 2025 Sep 4:120251. doi: 10.1016/j.jad.2025.120251. Online ahead of print.

ABSTRACT

BACKGROUND: Temperament has been increasingly studied in relation to neurodevelopmental disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD). This study examines the association between ADHD and affective temperament traits using the Temperament Scale of Memphis, Pisa, Paris, and San Diego (TEMPS-A) in a clinical outpatient sample in Beirut, Lebanon.

METHODS: This cross-sectional study included 2564 psychiatric outpatients aged 15 or older who completed the TEMPS-A. ADHD diagnosis was determined through clinical assessments based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria. Statistical analyses included descriptive comparisons and multivariate logistic regression, with temperament trait scores categorized based on Lebanese population norms.

RESULTS: Participants had an average age of 38.53 years, with females comprising 52.3 % of the sample. Bivariate analyses showed ADHD was associated with higher cyclothymic (CT), hyperthymic (HT), and irritable (IT) temperament trait scores. After adjusting for age, gender, and comorbidities, only IT remained a significant risk factor for ADHD (OR = 2.73, 95 % CI: 1.23-6.09), while depressive temperament trait (DT) emerged as a protective factor (OR = 0.38, 95 % CI: 0.17-0.87).

CONCLUSION: Our findings highlight the complex relationship between temperament traits and ADHD. IT was a significant risk factor, while DT unexpectedly appeared protective. These results underscore the need for further investigation into temperament traits as a diagnostic and therapeutic consideration in ADHD.

PMID:40914534 | DOI:10.1016/j.jad.2025.120251

J Affect Disord. 2025 Sep 4:120168. doi: 10.1016/j.jad.2025.120168. Online ahead of print.

ABSTRACT

BACKGROUND: Studies examining the association between maternal antibiotic use during pregnancy and the risk of childhood attention-deficit/hyperactivity disorder (ADHD) have yielded inconsistent results. This meta-analysis synthesizes available evidence to establish a more comprehensive understanding of this association.

METHODS: Observational studies published through October 2, 2024, were systematically searched from Cochrane Library, EMBASE, Web of Science, and PubMed databases. The Newcastle-Ottawa Scale was used to assess the quality of the included studies, and statistical analyses were performed using Stata version 15.0.

RESULTS: Nine studies encompassing 6,180,434 participants were included. Prenatal antibiotic exposure was associated with an increased risk of childhood ADHD (HR = 1.15; 95 % CI = 1.09-1.22, P < 0.0001; OR = 1.28; 95 % CI = 1.21-1.35, P < 0.001). Both mid-pregnancy (HR = 1.11; 95 % CI = 1.02-1.22, P = 0.282) and late-pregnancy (HR = 1.07; 95 % CI = 1.02-1.12, P = 0.521) antibiotic exposure was associated with an increased risk of ADHD. Repeated antibiotic exposures was associated with an increased risk further (twice: HR = 1.13; 95 % CI = 1.10-1.16, P = 0.856; ≥3 times: HR = 1.21; 95 % CI = 1.17-1.24, P = 0.166).

CONCLUSION: This analysis identified a link between maternal antibiotic use during pregnancy and an increased risk of childhood ADHD. Large-scale, multicenter, well-designed prospective studies are needed to confirm these findings and adjust for potential confounders in evaluating the relationship between prenatal antibiotic exposure and childhood ADHD.

PMID:40914530 | DOI:10.1016/j.jad.2025.120168

J Affect Disord. 2025 Sep 4:120208. doi: 10.1016/j.jad.2025.120208. Online ahead of print.

ABSTRACT

OBJECTIVES: It would be prudent to consider the mental health of psychiatrists, who are entrusted with the responsibility of caring for our mental well-being. This study aimed to examine psychiatrists’ mental health and coping strategies.

METHODS: The study was conducted among 217 psychiatry residents and specialists in Turkey. Data was collected via online test programs. The participants were given a Sociodemographic Form, the Brief COPE inventory, the Generalized Anxiety Disorder-7 Scale (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9).

RESULTS: The psychiatrists exhibited symptoms of poor mental health, with 35.5 % reporting anxiety and 12.4 % reporting depression. A statistically significant relationship was identified between burnout and depression and anxiety in the participants (p < 0.001, p < 0.001, respectively). A positive significant relationship was found between depression and emotion-focused coping style (R = 0.15, p = 0.025). Other statistically significant positive relationships were found between depression, anxiety and dysfunctional coping styles (R = 0.35, p < 0.001, R = 0.31, p < 0.001, respectively).

CONCLUSIONS: Psychiatrists should not neglect their mental health and that of their colleagues for the mental health of the community and should develop more functional coping strategies to deal with problems to carry the empathic burden of their profession.

PMID:40914523 | DOI:10.1016/j.jad.2025.120208

J Affect Disord. 2025 Sep 4:120209. doi: 10.1016/j.jad.2025.120209. Online ahead of print.

ABSTRACT

BACKGROUND: Laughter has been associated with mental and physical health benefits, but longitudinal evidence on whether laughter in daily life protects against depression remain limited. This study aimed to examine whether the frequency of laughter in daily life is associated with the risk of depression onset among older adults.

METHODS: We analyzed data from 32,666 adults aged ≥65 years participating in the Japan Gerontological Evaluation Study, a three-wave cohort conducted over six-years. Frequency of laughter was assessed in 2019 using a self-administered questionnaire with response categories: “almost every day”, “1-5 days per week”, “1-3 days per month”, and “never or almost never”. Depression onset during 2016-2022 was defined using the Geriatric Depression Scale. We fitted a modified Poisson regression model to estimate the adjusted risk ratios and their 95 % confidence intervals (CIs), controlling potential confounders measured in 2016.

RESULTS: During follow-up, 4805 (14.7 %) participants developed depression. Compared to those who laughed almost every day, those who laughed 1-5 days per week had 1.25 (95 % CI 1.09-1.44) times, those who laughed 1-3 days per week had 1.26 (95 % CI 1.05-1.52) times, and those who laughed never had 1.49 (95 % CI 1.18-1.89) times higher risks of depression. A significant dose-response trend was observed (P for trend<0.001).

CONCLUSION: Lower frequency of laughter in daily life was associated with an increased risk of depression onset in older adults. These findings suggest that frequent laughter may play a role in depression prevention in later life.

PMID:40914520 | DOI:10.1016/j.jad.2025.120209

J Nutr. 2025 Sep 4:S0022-3166(25)00542-5. doi: 10.1016/j.tjnut.2025.08.036. Online ahead of print.

ABSTRACT

BACKGROUND: An accurate understanding of protein requirements helps prevent health risks caused by deficiency. No statistical comparison exists between the nitrogen balance (NB) method, the standard method for estimating protein requirements, and the indicator amino acid oxidation (IAAO) method, which has been increasingly studied.

OBJECTIVE: To quantitatively compare the protein requirements of the NB and IAAO methods through meta-analyses.

METHODS: Studies estimating protein requirements in healthy individuals using the NB or IAAO methods were reviewed. First, previous reviews were systematically searched to identify original NB articles up to 2012 and IAAO articles up to 2023 from their references. Original articles published after each review’s search period, up to January 11, 2025, were systematically searched using PubMed and Ichushi-Web. Manual searches were performed through citation tracking of included literature and gray literature. This study followed PRISMA guidelines. Differences in protein requirements between assessment methods were compared using Welch’s t-test.

RESULTS: A total of 43 NB articles (777 participants) and 17 IAAO articles (186 participants) were included. In non-athletes, protein requirements were significantly higher by 36% with IAAO (mean: 0.88 g/kg/day; 95% confidence interval (CI): 0.85, 0.90) than with NB (mean: 0.64 g/kg/day; 95% CI: 0.61, 0.68). In athletes, protein requirements were significantly higher by 27% with IAAO (mean: 1.61 g/kg/day; 95% CI: 1.44, 1.78) than with NB (mean: 1.27 g/kg/day; 95% CI: 1.06, 1.47). In non-athletes, IAAO values remained significantly higher than NB values across age and sex subgroups.

CONCLUSIONS: The protein requirements calculated using the IAAO method were approximately 30% higher than those obtained using the NB method. The quantitative findings of this study provide important information for scientific consideration of protein requirements. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: This study was registered with PROSPERO as CRD42025636735.

PMID:40914512 | DOI:10.1016/j.tjnut.2025.08.036