Tag: nevin manimala

JAMA Netw Open. 2026 Aug 3;9(8):e2627595. doi: 10.1001/jamanetworkopen.2026.27595.

ABSTRACT

IMPORTANCE: A previous systematic review reported that general mental health and anxiety symptoms, but not depression or stress, worsened more for females or women than for males or men from before to during the COVID-19 pandemic based on 12 studies published up to August 2021.

OBJECTIVE: To update a systematic review on sex or gender differences in mental health symptom changes from before to during the COVID-19 pandemic.

DATA SOURCES: Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints were searched from December 31, 2019, to August 31, 2023.

STUDY SELECTION: Eligible studies included data to calculate changes in general mental health, anxiety symptoms, depression symptoms, or stress from before to during the COVID-19 pandemic by sex or gender.

DATA EXTRACTION AND SYNTHESIS: Standardized mean differences (SMDs) for continuous changes and proportions for dichotomous changes were used. Two independent reviewers extracted data and evaluated risk of bias. Data were pooled via random-effects models on March 21, 2024.

MAIN OUTCOMES AND MEASURES: The main outcome was the differences in SMD changes and proportions between women or females and men or males of mental health symptoms from before the COVID-19 pandemic to during the COVID-19 pandemic.

RESULTS: The study included 27 unique cohorts from 14 countries (n = 102-18 127; 31 155 women or females and 30 737 men or males). Differences in SMD change between men and women were minimal and not statistically significant for continuous outcomes of general mental health (0.01 [95% CI, -0.07 to 0.10 and 95% prediction interval (PI), -0.23 to 0.25]; 8 cohorts; 21 762 participants; heterogeneity [I2] = 81.4%), anxiety (0.09 [95% CI, -0.04 to 0.22 and 95% PI, -0.27 to 0.45]; 7 cohorts; 6039 participants; I2 = 68.7%), depression (0.10 [95% CI, -0.00 to 0.20 and 95% PI, -0.23 to 0.43]; 12 cohorts; 9750 participants; I2 = 65.4%), and stress (-0.08 [95% CI, -0.16 to 0.01 and 95% PI, -0.18 to 0.02]; 8 cohorts; 2994 participants; I2 = 0%). Substantial heterogeneity, high risk of bias, or both were present across analyses. No studies reported changes for gender minority groups (eg, transgender, nonbinary).

CONCLUSION AND RELEVANCE: In this systematic review and meta-analysis of sex or gender differences in mental health changes from before to during the COVID-19 pandemic, no significant differences were found. However, findings should be interpreted cautiously and may not apply in all settings due to heterogeneity and methodological limitations of included studies.

PMID:42560673 | DOI:10.1001/jamanetworkopen.2026.27595

JAMA Netw Open. 2026 Aug 3;9(8):e2627603. doi: 10.1001/jamanetworkopen.2026.27603.

ABSTRACT

IMPORTANCE: Illinois is an abortion hub serving a high volume of patients who travel from midwestern and southern states for abortion care. To sustain access to quality services and reduce health care barriers, research is needed to understand the experiences of abortion travelers.

OBJECTIVES: To explore the experiences of out-of-state individuals who travel to central and southern Illinois to receive abortion care.

DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used purposeful sampling to recruit 208 participants at 2 abortion clinics between November 2024 and August 2025. Participants completed the study at the time of recruitment.

EXPOSURE: Participants traveled for abortion care based on their state of residence.

MAIN OUTCOMES AND MEASURES: Using reflexive thematic analysis, both the experiences of out-of-state abortion travelers in central and southern Illinois and the need for reduction in access barriers for those traveling for abortion were examined.

RESULTS: In this qualitative study of 208 abortion seekers who successfully traveled to Illinois, 128 (61.54%) self-identified as Black, 50 (24.03%) non-Hispanic White, and 30 (14.42%) as women from additional minoritized racial and ethnic groups. Participants’ age ranged from 18 to 45 years. All lived in midwestern or southern states. Participants were interviewed in a private room at the clinic between November 2024 and August 2025. Participants discussed structural, logistical, and emotional challenges. Yet, they described abortion traveling as necessary because of the abortion ban and misinformation, which contributed to increased medical distrust. Medical distrust was already rooted in some participants’ previous experiences of receiving biased reproductive care, and for Black women, it worsened because of historical mistreatment and discrimination. Increased medical distrust likely drove people to travel for abortion care.

CONCLUSIONS AND RELEVANCE: These findings call for enhanced coordination of care with centralized trusted resources, equitable distribution of funding, mental health support, and attention to reduce biased care for Black women. The results also highlight the need to develop strategies to combat misinformation and increase advocacy efforts to reduce abortion stigma.

PMID:42560672 | DOI:10.1001/jamanetworkopen.2026.27603

J Speech Lang Hear Res. 2026 Aug 6:1-15. doi: 10.1044/2026_JSLHR-26-00145. Online ahead of print.

ABSTRACT

PURPOSE: Depression is prevalent yet frequently underdiagnosed. Although speech-based detection methods show promise, most prior studies have emphasized binary classification in nontonal languages. This study examined whether acoustic features of spontaneous Mandarin speech reflect depression as a categorical condition or a continuous, dimensional construct.

METHOD: A validated emotional Mandarin speech corpus paired with self-reported depression severity scores was analyzed. Acoustic features were extracted using the extended Geneva Minimalistic Acoustic Parameter Set. A multistage analytic framework was applied, including random forest classification to distinguish depressed from nondepressed clips, linear mixed-effects modeling to examine group and severity effects, and unsupervised clustering to examine latent structure in the acoustic feature space.

RESULTS: The random forest classifier achieved an accuracy of 72.3% and an area under the receiver operating characteristic curve of 0.826 on the held-out test set. Model performance favored sensitivity over precision in identifying depressed clips. SHapley Additive exPlanations analysis identified features across multiple acoustic domains, including spectral, pitch-related, voice quality, cepstral, and intensity measures, as important contributors to model predictions. Among the Top 10 features, no acoustic features showed statistically significant group differences. In contrast, median and mean fundamental frequencies were significantly positively associated with depression severity. Clustering analysis revealed overlapping group structures and a continuous distribution of severity scores across clusters.

CONCLUSIONS: These findings provide preliminary support for a dimensional conceptualization of depression in spontaneous Mandarin speech. While classification models can distinguish depressed from nondepressed speech with moderate accuracy, acoustic features appear to vary more consistently with symptom severity than with diagnostic group. Speech-based measures may therefore have potential for continuous monitoring of depression, although this possibility requires further longitudinal verification.

PMID:42560658 | DOI:10.1044/2026_JSLHR-26-00145

Child Dev. 2026 Aug 6:aacag141. doi: 10.1093/chidev/aacag141. Online ahead of print.

ABSTRACT

This systematic review and meta-analysis provides the first comprehensive synthesis of research on emotion regulation (ER) in children and adolescents with developmental language disorder (DLD), based on 16 independent samples (NDLD = 1,616; ages 5-16). Individuals with DLD showed significantly greater ER difficulties than typically developing peers, representing a medium effect size (g = 0.563). This effect remained statistically significant, although reduced to a small-to-medium effect size, in sensitivity analyses excluding studies from the same research group (g = 0.317). Informant discrepancies emerged, with teachers reporting more ER difficulties than parents and children’s self-reports. No clear evidence of publication bias was observed on formal testing; however, converging evidence from small-study effects, risk of bias analyses, and publication year trends suggests that the observed effect size may represent an overestimate of the true effect. These findings underscore the need for more rigorous, theory-driven, multi-method research to accurately estimate the magnitude of ER difficulties in DLD.

PMID:42560654 | DOI:10.1093/chidev/aacag141

Res Health Serv Reg. 2026 Aug 6;5(1):11. doi: 10.1007/s43999-026-00095-3.

ABSTRACT

INTRODUCTION: More than 90% of the highest incidence rates of cervical cancer occur in sub-Saharan Africa region. However, this region has low uptake of cervical cancer screening compared to other World Health Organization (WHO) regions. Therefore, the current study aimed to show the geographical and regional variation and predictors of low uptake of cervical cancer screening among women aged 30-49 years in Tanzania.

METHODS: This study analyzed data from 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS). The uptake of cervical cancer screening was the outcome variable which dichotomized into “Yes” for the women who reported a doctor or other healthcare provider ever tested her for cervical cancer otherwise it was coded “No.” Besides, descriptive and geospatial analysis, the mixed-effect multilevel logistic regression analysis was performed to determine predictors of low uptake of cervical cancer screening.

RESULTS: This study included a total of 6911 women between 30 and 49 years old, with the median age (interquartile range) of 38 (34-43) years. The overall uptake of cervical cancer in Tanzania remain low (12.2%). The geospatial analysis indicates the lowest uptake was observed in Southern (4.7%) and Central (5.9%). The random effect model revealed that the variation in uptake of cervical cancer screening, 26% was attributed to between clusters within regions or geographical zones differences [ICC = 0.26, 95%CI; 0.22-0.31]. Fixed effect model revealed that women with older ages, formal education, health insurance coverage, employed for cash, being in rich household, listen to radio, reading newspapers, magazines, or using the internet had higher odds of uptake cervical cancer screening than their counterparts.

CONCLUSION: For realization of WHO target on elimination of cervical cancer by screening 70% of all eligible women age 30 and above by 2030, more efforts on addressing social determinants of health and provision of health education through mass media should be considered.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42560633 | DOI:10.1007/s43999-026-00095-3

J Robot Surg. 2026 Aug 6;20(1):803. doi: 10.1007/s11701-026-03785-9.

ABSTRACT

Hilar lymph nodes with dense adhesion to the bronchus and pulmonary artery (“doornail” nodes) can be encountered unexpectedly during robot-assisted pulmonary resection. We report our experience managing these nodes and associated factors. This retrospective single-center cohort study included 1,185 patients undergoing robot-assisted pulmonary resection (March 2021-September 2024). Preoperative factors were analyzed using Firth penalized logistic regression in a clinically selected model (age, maximal voluntary ventilation [MVV], and tumor diameter). Operative time and blood loss were compared using robust regression models. Perioperative outcomes were compared descriptively between attempted separate dissection and en bloc stapling. Doornail hilar lymph nodes occurred in 48 of 1,185 patients (4.05%; 95% CI, 3.07-5.33%). Older age remained associated with this finding after adjusting for MVV and tumor diameter (adjusted OR per 10 years, 2.316; 95% CI, 1.533-3.596; P<0.001). Operative time was longer unadjusted (105 vs 92 min; P=0.027) but not after adjustment. Among these 48 patients, 45 (93.8%) received en bloc stapling with no blood loss exceeding 200 mL, transfusion, or prespecified in-hospital complication, whereas all 3 (6.3%) who underwent attempted separate dissection had substantial bleeding (700-2,400 mL), and 2 required transfusion. No conversion to thoracotomy occurred. Doornail hilar lymph nodes occurred in about 4% of patients; older age remained associated with this finding after adjusting for MVV and tumor diameter. Because strategy selection was non-random and groups differed in resection extent, comparative safety cannot be established; en bloc stapling after tissue thinning may be feasible when a node cannot be safely separated.

PMID:42560620 | DOI:10.1007/s11701-026-03785-9

Photochem Photobiol Sci. 2026 Aug 6. doi: 10.1007/s43630-026-00962-5. Online ahead of print.

ABSTRACT

BACKGROUND: The Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) laser is proposed as an adjunct to scaling and root planing (SRP) to enhance bacterial reduction and healing in periodontitis. This study aims to evaluate the efficacy of Nd: YAG laser therapy (1064 nm) compared with SRP alone in improving clinical periodontal outcomes.

METHODS: This systematic review adhered to PRISMA 2020 guidelines and was prospectively registered with PROSPERO. We included only randomized controlled trials (RCTs) comparing SRP with adjunctive Nd: YAG laser therapy to SRP alone in patients with periodontitis. The primary outcomes were pocket depth (PD), plaque index (PI), bleeding on probing (BOP), and clinical attachment loss (CAL) assessments at baseline and after three months. Secondary outcomes included gingival cervical fluid (GCF) at baseline and after three months. Risk-of-bias assessment (using ROB-2) was performed independently by multiple reviewers. All statistical analyses were performed using R (version 4.4.3). The certainty of evidence for all outcomes was evaluated using the GRADE approach.

RESULTS: The systematic review and meta-analysis included 22 randomized controlled trials published between 2010 and 2025, totaling 776 patients. Meta-analysis demonstrated that adjunctive ND: YAG laser with SRP significantly improved PD reduction compared with SRP alone (MD = – 0.46 mm; 95% CI -0.82 to – 0.10; p = 0.0117), Subgroup analysis showed that split-mouth RCTs had a larger effect (MD = – 0.66 mm) than parallel-group RCTs (MD = – 0.20 mm), but the difference between subgroups was not significant. No statistically significant benefits were observed for PI (MD = – 0.03; 95% CI -0.19 to 0.13; p = 0.63), CAL (MD = – 0.04; 95% CI -0.21 to 0.13; p = 0.61), GCF volume (MD = – 0.20; 95% CI -0.45 to 0.06; p = 0.097), or BOP (MD = – 7.88; 95% CI -19.23 to 3.46; p = 0.17).

CONCLUSION: Adjunctive Nd: YAG laser therapy provides a modest, statistically significant benefit in reducing periodontal pocket depth beyond conventional therapy alone. However, it does not demonstrate superior efficacy in improving clinical attachment levels or plaque control. Consequently, while beneficial for pocket reduction, current evidence does not support its routine universal use as a substitute for standard mechanical debridement.

PMID:42560618 | DOI:10.1007/s43630-026-00962-5

Neurosurg Rev. 2026 Aug 6;49(1):517. doi: 10.1007/s10143-026-04439-y.

ABSTRACT

Although enhanced recovery after surgery (ERAS) has demonstrated benefits in various surgical specialties, evidence supporting its application in elective glioma craniotomies remains limited. This study compared the institutional ERAS pathway with conventional perioperative care in adults undergoing elective craniotomy for a single cerebral glioma. This retrospective cohort study (2019-2024) at a Thai university hospital enrolled patients aged ≥ 15 years with histologically confirmed gliomas. Propensity score matching (PSM; 1:1) addressed measured baseline confounding, and inverse probability of treatment weighting (IPTW) served as a sensitivity analysis. The primary outcomes were total hospital length of stay (LOS), intensive care unit (ICU) LOS, and postoperative LOS. Of 153 eligible patients (ERAS, n = 58; conventional, n = 95), PSM yielded 53 matched pairs. The ERAS group had shorter median total (9 vs. 12 days; p = 0.004) and postoperative (7 vs. 9 days; p = 0.037) LOS, with equivalent ICU LOS, hospitalization costs, and complication rates. The results of the IPTW analysis were directionally consistent. In multivariable logistic regression analyses, 2-hour preoperative carbohydrate loading (adjusted odds ratio [95% confidence interval] 5.98 [1.08-33.02], p = 0.040) and early oral fluid intake within postoperative 8 h (5.74 [1.22-26.96], p = 0.027) independently predicted a short postoperative LOS (< 7 days). Thus, ERAS was associated with shorter hospital stay without increased complications. Preoperative carbohydrate loading and early oral fluid intake were independently associated with a short postoperative LOS, identifying them as high-priority targets for a pragmatic, stepwise implementation strategy for ERAS in elective glioma craniotomies. Prospective multicenter studies are required to further optimize this pathway.

PMID:42560602 | DOI:10.1007/s10143-026-04439-y

Matern Child Health J. 2026 Aug 6. doi: 10.1007/s10995-026-04310-y. Online ahead of print.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition. Diagnosis is based on developmental history and behavioral observation. Parental age has been identified as a potential risk factor for ASD.

OBJECTIVES: This study aimed to assess the association between maternal age, paternal age, parental education level, smoking history, and ASD risk.

METHODS: This case-control study included 154 individuals with ASD and 335 controls. Demographic, clinical, and familial data were collected through structured questionnaires and interviews. Statistical analysis included descriptive statistics and chi-square tests for categorical variables.

RESULTS AND DISCUSSION: A total of 489 participants were included (154 ASD cases and 335 controls). The ASD group was predominantly male (77%), compared with the control group (68%). Mothers in both groups most commonly held a bachelor’s degree (40%), while fathers showed more variable educational backgrounds. A family history of ASD was significantly more frequent in the ASD group (23%) compared with controls (5.4%), whereas a family history of psychiatric disorders showed no significant difference (15% vs. 11%). NICU admission (11% vs. 2.4%) and preterm delivery (7.3% vs. 1.8%) were more common in the ASD group. In multivariable analysis, paternal age (adjusted OR = 1.08, 95% CI: 1.03-1.14), maternal age (adjusted OR = 1.09, 95% CI: 1.03-1.15), male sex (adjusted OR = 4.13, 95% CI: 2.38-7.16), and family history of ASD (adjusted OR = 2.40, 95% CI: 1.09-5.30) were independently associated with ASD.

CONCLUSIONS: ASD risk was independently associated with parental age, male sex, and family history of ASD, highlighting the role of genetic and demographic factors. Prospective longitudinal studies are needed to further clarify ASD risk trajectories.

PMID:42560598 | DOI:10.1007/s10995-026-04310-y

Environ Monit Assess. 2026 Aug 6;198(9):920. doi: 10.1007/s10661-026-15752-w.

ABSTRACT

This study integrates longitudinal groundwater monitoring, spatiotemporal plume modeling, and deterministic health risk assessments to evaluate petroleum-derived contamination at an urban fuel station on the European side of Istanbul, Turkey. Over a 20-month monitoring period encompassing ten sampling events, the spatiotemporal distribution of benzene, toluene, ethylbenzene, xylenes (BTEX), methyl tert-butyl ether (MTBE), and total petroleum hydrocarbons (TPH) was analyzed using the Groundwater Spatiotemporal Data Analysis Tool (GWSDAT). Results revealed significant subsurface migration governed by the local hydraulic gradient, with maximum concentrations peaking at 79,000 µg/L for MTBE at the facility boundary and 5100 µg/L for benzene. MTBE acted as a high-mobility tracer, forming the leading edge of the dissolved-phase plume and demonstrating active off-site migration vectors into the adjacent unconfined aquifer. To quantify the resulting environmental liabilities, Tier 3 human health risk modeling was conducted using the Risk-Integrated Software for Cleanups (version 5.0) framework for adult and child receptors across ingestion, dermal, and inhalation pathways. The assessment indicated a severe, unacceptable non-carcinogenic threat to pediatric populations, with a cumulative hazard index (HI) reaching 13, driven primarily by the inhalation of indoor vapors volatilizing from the subsurface plume. For adults, the cumulative HI was 3.9, while the excess lifetime cancer risk (ELCR) exceeded the standard regulatory safety threshold of 1 × 10^-6 due to persistent benzene mass flux. Probabilistic sensitivity analysis identified exposure duration and the soil-to-indoor air attenuation factor as the most critical parameter uncertainties. These concrete toxicological metrics demonstrate that natural attenuation alone is insufficient. Consequently, an adaptive remediation framework, utilizing in situ chemical oxidation (ISCO) for the mobile MTBE leading edge and soil vapor extraction (SVE) for the volatile BTEX source, is required, providing quantitative justification for municipal authorities to enforce strict land-use setbacks and mandatory indoor vapor screening.

PMID:42560596 | DOI:10.1007/s10661-026-15752-w