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The simple view of reading describes reading as the product of decoding (D) and listening comprehension (LC). However, the simple view of reading has been challenged, and evidence has proved it to be too simple to explain the complexities of reading comprehension in the elementary school years. Hypotheses have been advanced that there are cognitive-linguistic factors that underlie the common variance between D and LC, which are malleable, although there is no clarity at this point regarding what these are. We propose that one such group of malleable cognitive factors is executive function (EF) skills. Further, we posit that EF skills play equally strong roles in explaining reading comprehension variance in emergent bilinguals and English monolinguals. We used multigroup structural equation modeling to determine the contribution of these constructs (D, LC, and EF) to reading comprehension in 425 emergent bilinguals and 302 English monolinguals in grades 2–4. The shared variance between D and LC was explained by direct and indirect effects in the models tested, with strong indirect effects for the EFs of cognitive flexibility and working memory through D and LC, respectively, for both language groups. The indirect effect of cognitive flexibility through LC on reading comprehension was considerably larger for emergent bilinguals than for English monolinguals. Considerations for a more nuanced view of the simple view of reading and its implications for practice are discussed.

Socioemotional constructs have been receiving increased attention as contributors to individuals’ literacy development. However, in comparison with positive socioemotional constructs, negative socioemotional constructs have been understudied with respect to their role in reading achievement in both emergent bilinguals (EBs) and English monolinguals (EMs). In the present study, we addressed this gap by examining reading anxiety in 339 EBs, who primarily spoke Spanish as their first language, and 178 EMs in grades 3–5, using a latent variable approach. We used structural equation modeling to form latent variables for reading anxiety, reading engagement, and reading achievement; compare latent variable means for EBs and EMs; and examine relations among the three focal constructs across the two language groups. The EBs and EMs showed similar levels of reading engagement, whereas the EBs showed a trend toward greater reading anxiety and statistically significantly lower reading achievement. Further, for both EBs and EMs, reading anxiety related negatively to reading achievement, both directly and indirectly through reading engagement, controlling for grade level. However, both the direct and indirect effects were greater for EBs than EMs. We interpret these results in the context of theoretical views of potential mechanisms linking reading anxiety and achievement, giving attention especially to the multidimensional nature of reading engagement. Based on the current findings and those of other research, we conclude by contending that reading anxiety merits increased scrutiny by researchers and educators endeavoring to understand and strengthen students’ reading achievement and socioemotional development during the elementary school years.

Reading comprehension is an incredibly complex, purposeful activity that involves simultaneous orchestration and integration of multiple processes. However, dominant perspectives suggest that two clusters of skills, word reading and language comprehension, account for successful reading. Such two-factor models are problematic because they do not easily account for complexities in reading comprehension processes or for contributions to reading comprehension of other individual difference variables related to the purposeful nature of reading, such as executive functions (EFs) and intrinsic motivation. Further, simple models may lead to oversimplification of research questions, curricula, and instructional practices, causing researchers and educators to miss important contributors to reading comprehension necessary for students to develop into skilled readers. In this study, the authors assessed the unique contributions of EFs, both domain-general and reading-specific, and cognitive intrinsic motivation (i.e., the desire to engage in effortful cognitive activities) to reading comprehension in 122 university students beyond language comprehension and word-reading skills. Findings confirm unique contributions of cognitive intrinsic motivation and reading-specific EF to students’ reading comprehension beyond established predictors and domain-general EFs. Findings also suggest complexities, such as impacts of language comprehension on word reading, as well as impacts of cognitive intrinsic motivation on both language and reading comprehension, that should be considered in theory and practice. Finally, because reading-specific EF contributed to reading comprehension directly and indirectly beyond controls, these findings underscore the importance of applying knowledge of EF to specific reading processes to better support students who struggle to understand text.

Endothelial dysfunction (ED) is an early marker of cardiovascular disease (CVD), influenced by both physiological and psychosocial factors. While depression and anxiety are known contributors to ED, the role of spiritual well-being (SWB) in vascular health has been relatively less explored in the literature. To investigate the association between SWB and ED in clinically healthy adults, controlling for mental health variables and conventional cardiovascular risk factors. In this cross-sectional study, 148 individuals aged 18-60 years were assessed using validated instruments: FACIT-Sp for SWB, PHQ-9 for depression, GAD-7 for anxiety, and brachial artery flow-mediated dilation (FMD) for endothelial function. Logistic regression and discriminant analyses were performed to identify independent predictors of ED and the spiritual dimensions most associated with vascular health. ED was identified in 39.2% of participants. Multivariate logistic regression indicated that SWB (OR = 0.929; p = 0.005), body mass index (OR = 1.130; p = 0.016), generalized anxiety disorder (OR = 2.551; p = 0.035), and major depressive episode (OR = 3.740; p = 0.038), were significantly associated with ED. Among these, SWB was significantly inversely associated with ED even after excluding participants with anxiety or depression. Discriminant analysis further indicated that inner peace and life purpose-but not faith-significantly distinguished individuals with and without ED. SWB, particularly dimensions related to inner peace and meaning, is independently associated with preserved endothelial function in healthy adults. These findings support the inclusion of psychosocial and spiritual dimensions in cardiovascular risk assessment and prevention strategies.

Previous studies offer mixed evidence regarding whether a unified model of reading comprehension predictors applies to Dual Language Learners (DLLs) and English Speakers (ESs), or whether distinctive models across language groups are empirically supported. The present study adds another dimension to this body of work by examining multiple reading engagement and motivation predictors alongside cognitive predictors of reading comprehension. The participants—188 DLLs and 166 ESs in the fourth and fifth grades—completed measures of word identification, linguistic comprehension, cognitive strategy use, internal motivation, and extrinsic motivation, and their teachers rated their reading engagement. Language status did not moderate the relations of any predictors with either concurrent reading comprehension performance or growth of reading comprehension across the school year, supporting a unified model of reading comprehension for DLLs and ESs. Word identification and linguistic comprehension showed the strongest relations with concurrent reading comprehension and growth. While the role of reading engagement was less prominent, it was demonstrated to be a plausible partial mediator of the relation of word identification with concurrent reading comprehension.

Anxiety symptoms (AS) are exacerbated in healthcare workers (HCWs) during the COVID-19 pandemic. Spirituality is known to protect against AS in the general population and it is a construct that differs from religion. It can be assessed using structured questionnaires. A validated questionnaire disclosed three spirituality dimensions: peace, meaning, and faith. In HCWs we investigated the predictors of chronic anxiety (pre-COVID-19 and during the pandemic) and acute anxiety (only during the pandemic), including spirituality in the model. Then, we verified which spirituality dimensions predicted chronic and acute anxiety. Lastly, we studied group differences between the mean scores of these spirituality dimensions. The study was carried out in a Brazilian Hospital. HCWs (n = 118) were assessed for spirituality at a single time-point. They were also asked about AS that had started pre-COVID-19 and persisted during the pandemic (chronic anxiety), and AS that had started only during the pandemic (acute anxiety). The subjects without chronic anxiety were subdivided into two other groups: acute anxiety and without chronic and acute anxiety. Forward stepwise logistic regressions were used to find the significant AS predictors. First, the model considered sex, age, religious affiliation, and spirituality. Then, the analysis were performed considering only the three spirituality dimensions. Group means differences in the spirituality dimensions were compared using univariate ANCOVAS followed by T-tests. Spirituality was the most realible predictor of chronic (OR = 0.818; 95%CI:0.752-0.890; p<0.001) and acute anxiety (OR = 0.727; 95%CI:0.601-0.881; p = 0.001). Peace alone predicted chronic anxiety (OR = 0.619; 95%CI:0.516-0.744; p<0.001) while for acute anxiety both peace (OR:0.517; 95%CI:0.340-0.787; p = 0.002), and faith (OR:0.674; 95%CI:0.509-0.892; p = 0.006) significantly contributed to the model. Faith was significantly higher in subjects without AS. Higher spirituality protected against chronic and acute anxiety. Faith and peace spirituality dimensions conferred protection against acute anxiety during the pandemic.

IntroductionGenitourinary syndrome of menopause (GSM) is a chronic, oestrogen-deficient condition that is frequently underdiagnosed and undertreated. Although low-dose vaginal estriol improves epithelial trophism and microbial balance, a substantial proportion of women report persistent symptoms. High-quality randomised evidence evaluating combined therapeutic strategies remains scarce. Energy-based modalities, including the erbium:YAG (Er:YAG) laser (λ=2940 nm), have been proposed as adjunctive treatments. This trial aims to assess the efficacy of Er:YAG laser therapy combined with vaginal estriol compared with estriol alone in postmenopausal women with GSM.Methods and analysisThis is a single-centre, randomised, double-blind, controlled clinical trial. Postmenopausal women aged 45–70 years with vaginal pH ≥5.0 and at least one moderate GSM symptom (Visual Analogue Scale ≥4) will be eligible. Exclusion criteria include current systemic or local hormone therapy, previous vaginal energy-based treatment, abnormal cervical cytology and body mass index ≥35 kg/m2. All participants will receive vaginal estriol cream (0.5 mg per dose) daily for 14 days, followed by twice-weekly administration for 16 weeks. Participants will be randomised (1:1) to receive either estriol plus sham Er:YAG laser or estriol plus active Er:YAG laser. Three laser sessions will be delivered at approximately 4-week intervals. Assessments will occur at baseline, monthly during treatment and 4 months after the final session. The primary outcome is the Vulvovaginal Health Index, with the primary endpoint defined as the change from baseline to 4 months post-treatment, reflecting sustained effect. Secondary outcomes include GSM symptom severity, vaginal microbiome composition (16S rRNA sequencing), quality of life (Menopause Rating Scale) and sexual function (Female Sexual Function Index). Data will be analysed using repeated-measures analysis of variance or appropriate non-parametric tests, with significance set at p<0.05.Ethics and disseminationEthical approval has been obtained from the Human Research Ethics Committee of UNINOVE. Written informed consent will be obtained. Findings will be disseminated via peer-reviewed journals and scientific meetings.Trial registration numberNCT06873971.

The authors examined how motivational and cognitive variables predict reading comprehension, and whether each predictor variable adds unique explanatory power when statistically controlling for the others. Fourth-grade students ( N  = 205) completed measures of reading comprehension in September and December of the same year, and measures of background knowledge and cognitive strategy use in December. Teachers rated internal reading motivation of each student. Results from multiple regression analyses showed that motivation, background knowledge, and cognitive strategy-use made significant, independent contributions to children’s reading comprehension when the other predictor variables were controlled. Further analyses showed the same cognitive and motivational variables predicted growth over a 3-month period in reading comprehension. Possible explanations of the observed relations between motivation, cognitive variables, and reading comprehension are presented.

IntroductionThe objective is to investigate the effect of antimicrobial photodynamic therapy (aPDT) mediated by erythrosine and a blue light-emitting diode (LED) in the reduction of bacteria in dental biofilm.Methods and analysisThis clinical trial will be conducted with 30 patients who have biofilm, but without the presence of periodontal pockets, and who are being treated at the Dental Clinic of Universidade Metropolitana de Santos. A split-mouth model will be used (n=30), with group 1 control (conventional treatment) and group 2 (conventional treatment and aPDT). The bicarbonate jet will be used to remove dental biofilm in both groups. The treatment will be carried out in one session. aPDT will be performed before cleaning/prophylaxis, only in group 2. Participants will rinse with the photosensitiser erythrosine (diluted to 1 mM) for 1 min of pre-irradiation time, so that the drug can stain all the bacterial biofilm. Then, the D-2000 LED (DMC) will be applied, emitting at a wavelength of ʎ=470 nm, radiant power of 1000 mW, irradiance of 0.532 W/cm2 and radiant exposure of 63.8 J/cm2. Irradiation will be performed until the biofilm of the cervical region is illuminated for 2 min/point (4 cm2). The microbiological examination will be performed from samples of supragingival biofilm collected from the gingival sulcus. Collection will be performed in each experimental site before irradiation, immediately after the irradiation procedure and after the prophylaxis. Colony-forming units will be counted and the data will be submitted for statistical analysis for comparison of pretreatment and post-treatment results and between groups (conventional X aPDT).Ethics and disseminationThis study has been approved by the Ethics Committee of Universidade Metropolitana de Santos under process number 66984123.0.0000.5509. Results will be published in peer-reviewed journals and will be presented at conferences.Trial registration numberNCT05805761.

The aim of the study was to evaluate the release of the lingual frenulum through frenectomy in newborns zero to 90 days of age who breastfed and had diagnosis of ankyloglossia with an indication for surgery, comparing two methods: electrocautery and a high-power diode laser. Fifty-seven patients were randomly allocated to two groups (23 submitted to electrocautery and 34 submitted to a high power diode laser). Tongue movements were evaluated based on a clinical assessment and using the Bristol Tongue Assessment Tool (BTAT) before and 15 days after the surgical procedures. The visual analog scale was administered to the mothers on the same occasions for the measurement of pain during breastfeeding. Both groups had an increased BTAT score (favorable outcome) at the post-surgical evaluation, but the anterior third of the tongue was not always free to enable the movements necessary for lingual functions. It is fundamental for surgeons to have skill and in-depth knowledge of the equipment used to avoid accidents and complications in the region of important structures. Both techniques employed in this study were safe and effective, causing little bleeding and few postoperative complications. The group submitted to a high-power diode laser exhibited less post-surgical bleeding compared to the group submitted to electrocautery and no inflammation at the edges of the surgical cut.