Nevin Manimala

Neural Netw. 2026 Jan 7;198:108520. doi: 10.1016/j.neunet.2025.108520. Online ahead of print.

ABSTRACT

The paper presents novel Universum-enhanced classifiers: the Universum Generalized Eigenvalue Proximal Support Vector Machine (U-GEPSVM) and the Improved U-GEPSVM (IU-GEPSVM) for EEG signal classification. Using the computational efficiency of generalized eigenvalue decomposition and the generalization benefits of Universum learning, the proposed models address critical challenges in EEG analysis: non-stationarity, low signal-to-noise ratio, and limited labeled data. U-GEPSVM extends the GEPSVM framework by incorporating Universum constraints through a ratio-based objective function, while IU-GEPSVM enhances stability through a weighted difference-based formulation that provides independent control over class separation and Universum alignment. The models are evaluated on the Bonn University EEG dataset across two binary classification tasks: (O vs S)-healthy (eyes closed) vs seizure, and (Z vs S)-healthy (eyes open) vs seizure. IU-GEPSVM achieves peak accuracies of 85% (O vs S) and 80% (Z vs S), with mean accuracies of 81.29% and 77.57% respectively, outperforming baseline methods. Rigorous statistical validation confirms these improvements: Friedman tests reveal significant overall differences, pairwise Wilcoxon signed-rank tests with Bonferroni correction establish IU-GEPSVM’s superiority over all baselines, and win-tie-loss analysis demonstrates practical significance. Overall, integrating interictal Universum data yields an efficient and reliable solution for neurological diagnosis.

PMID:41538899 | DOI:10.1016/j.neunet.2025.108520

J Radiol Prot. 2026 Jan 15. doi: 10.1088/1361-6498/ae38ee. Online ahead of print.

ABSTRACT

Thirteen years after the Fukushima nuclear accident, Fukushima Prefecture still faces major challenges in recovery, especially concerning the negative image. Perception of spatial stigma refers to the residents’ concerns about the negative image of their region and its residents as perceived by the public. The present study aims to clarify the perception of spatial stigma and its associated factors among residents.
A questionnaire survey was conducted among local residents from December 2023 to January 2024 in Tomioka, Okuma, and Futaba towns. Statistical analysis was done using the chi-square test and logistic regression.
67.8% of participants expressed a strong perception of spatial stigma. Perception of spatial stigma was independently correlated with living in the FDNPP location, high radiation health risk perception, anxiety about treated water release, uncertainty of returning, and poor mental health.
Actively addressing the stigma of Fukushima through targeted countermeasures is crucial for alleviating residents’ perception of spatial stigma. These efforts are vital for fostering recovery and achieving comprehensive revitalization of Fukushima Prefecture.

PMID:41538886 | DOI:10.1088/1361-6498/ae38ee

JMIR Form Res. 2026 Jan 15;10:e70809. doi: 10.2196/70809.

ABSTRACT

BACKGROUND: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are responsible for a significant amount of the economic and chronic disease burden that impacts the Ontario health system. Telehomecare, a home self-management program launched by the Ontario Telemedicine Network (OTN), was created to improve access to quality care and limit health care use. However, few data are available on patient-, caregiver-, and provider-reported outcomes of telehomecare.

OBJECTIVE: This study aims to evaluate the impact of the OTN telehomecare program on the health-related quality of life (HRQoL), disease-management skills, and satisfaction of patients with HF and those with COPD; informal caregiver strain index; and nurse satisfaction with telehomecare.

METHODS: We used a prospective longitudinal cohort design, including patients with HF and those with COPD enrolled in Ontario’s telehomecare program, informal caregivers of patients in the program, and nurses providing services in telehomecare. Patients and informal caregivers were administered telephone surveys at baseline, month 3, month 6, and month 12 follow-up from July 2016 to December 2019. The outcomes for the longitudinal surveys were patient-perceived HRQoL, disease self-management skills, perception of telehomecare (ease of use and usefulness), satisfaction with telehomecare, and informal caregiver-perceived strain. Cross-sectional surveys were conducted with nurses to assess nurse perception and satisfaction with telehomecare. Participant data were analyzed using general linear mixed models in SAS Statistical Software (version 9.4; SAS Institute Inc).

RESULTS: Overall, a total of 194 patients (HF, n=117; COPD, n=77), 62 caregivers, and 24 nurses participated, with an overall response rate of 51% (280/551). The average age of patients with HF and those with COPD was 71 (SD 11.3) years and 70 (SD 11.1) years, respectively, and 52% (100/194) were men. A significant improvement in overall HRQoL was observed among patients with HF at month 12 (-18.37, P<.001). Minimal clinically important differences were observed across all HRQoL domains for people with HF, indicating clinically meaningful improvement over the study period. No statistically significant improvement in HRQoL was observed among patients with COPD; however, minimal clinically important differences were observed in the physical functioning dimension. Patients reported being confident in self-managing their diseases throughout the study, but as patients aged, their perception of and satisfaction with telehomecare was shown to decrease (P=.002 and P=.002, respectively). Caregivers reported relatively low strain scores (mean 10.3, SD 5.9) throughout the program, and nurses reported moderate levels of satisfaction (mean 6.7, SD 1.5) with telehomecare at follow-up.

CONCLUSIONS: In this population, telehomecare demonstrated an ability to improve the HRQoL of patients with HF and those with COPD. However, the long-term sustainability of HRQoL improvements in patients following telehomecare requires further investigation. Furthermore, telehomecare was shown to decrease informal caregiver-perceived strain, and nurses described moderate levels of satisfaction and perceived quality of care with telehomecare.

PMID:41538796 | DOI:10.2196/70809

JMIR Res Protoc. 2026 Jan 15;15:e82806. doi: 10.2196/82806.

ABSTRACT

BACKGROUND: Despite the widespread use of inhalation therapy, patients with chronic obstructive pulmonary disease (COPD) frequently experience suboptimal disease control due to medication nonadherence, improper inhaler use technique, and inappropriate device selection, which collectively impair health-related quality of life (HRQoL). Pharmacist-led interventions may help address these gaps. Interventions based on the information-motivation-behavioral skills model and supported by digital tools can improve adherence and self-management. This study evaluates the efficacy of a multifaceted pharmaceutical care intervention for COPD delivered through digital tool support.

OBJECTIVE: The primary objective is to compare the change in HRQoL, measured using the St George’s Respiratory Questionnaire, between the intervention and control groups from baseline to 12 months. Secondary objectives are to assess changes in medication adherence (Test of Adherence to Inhalers), quality of life (EQ-5D-5L), COPD-related medical costs, and patient-reported pharmacy service experience.

METHODS: This 1-year cluster randomized controlled trial evaluates a multifaceted pharmaceutical care intervention in adults with moderate to very severe COPD (Global Initiative for Chronic Obstructive Lung Disease, stages 2-4) who have confirmed suboptimal inhaler practice but remain matched to an appropriate inhaler device based on peak inspiratory flow rate measured using a digital tool. In total, 34 hospital-based cough and wheeze pharmaceutical care clinics were recruited and randomized (1:1) to either an intervention or a control group. The target sample size is 15 patients per site. Participants in the intervention group will receive tailored support using electronic adherence monitoring, inhaler use technique assessments, and peak inspiratory flow rate to optimize device selection and self-management. Participants in the control group will receive usual pharmaceutical care. Descriptive statistics will be used to summarize participant characteristics and outcomes. Linear mixed effects models will be used to compare primary and secondary outcomes. Subgroup analyses will explore effects by age, sex, education level, place of residence, and smoking status. Pharmacy service survey data will be analyzed qualitatively.

RESULTS: The trial was registered on July 15, 2024. Recruitment started on November 9, 2024, and enrollment was completed by December 31, 2025. As of December 31, 2025, we enrolled 454 participants, of whom 16 (3.5%) had completed the 12-month follow-up. The trial is expected to be completed by December 31, 2026, with results planned for publication in 2027.

CONCLUSIONS: This multifaceted, pharmacist-led pharmaceutical care intervention may provide a scalable model for improving COPD management and HRQoL. If effective, the digitally supported program, grounded in the information-motivation-behavioral skills model, could be implemented in more than 1000 cough and wheeze pharmaceutical care clinics nationwide.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2400086943; https://tinyurl.com/75a9phbw.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/82806.

PMID:41538791 | DOI:10.2196/82806

JMIR Cancer. 2026 Jan 15;12:e78968. doi: 10.2196/78968.

ABSTRACT

BACKGROUND: Cancer survivors face significant challenges in maintaining adequate physical activity levels, which are essential for overall health and quality of life. Telehealth-based interventions offer promising opportunities to provide accessible support and promote healthier lifestyles throughout the cancer survivorship continuum. HealthScore is a telehealth coaching program designed to optimize the health of cancer survivors.

OBJECTIVE: This study assessed the effectiveness of HealthScore in improving physical activity metrics among cancer survivors compared to controls. We also evaluated participants’ qualitative experiences with the program to understand its impact on motivation, accountability, and overall health-related quality of life.

METHODS: We performed a secondary analysis of a randomized controlled study of cancer survivors who participated in a comprehensive health coaching intervention called HealthScore. Participants in control and intervention groups received a Fitbit activity tracker that collected heart rate, step counts, active minutes, and calories burned. These metrics were analyzed using statistical methods to compare overall averages and temporal trends between intervention and control groups. Eleven exit interviews were conducted with intervention arm participants to ascertain their experiences with HealthScore. Inductive thematic analysis was performed to identify emerging themes. Data were collected between May 2020 and March 2022.

RESULTS: Of the 32 participants enrolled, 20 (62%) were in the intervention group. Compared to the control group, intervention participants had significantly higher average daily steps (mean 3660, SD 3344; 95% CI 3557-3764 vs mean 3408, SD 3288; 95% CI 3299-3518; P=.001) and more moving average daily steps (mean 4813, SD 1723; 95% CI 4680-4946 vs mean 4581, SD 1224; 95% CI 4494-4669; P=.003). Moving average daily step counts in the intervention arm showed an increasing trend, which was significantly higher than that of the control group (regression slope=5.89 vs 2.80; P<.001). Compared to the control group, the intervention participants had significantly higher average daily walking distance (mean 2.6, SD 2.5; 95% CI 2.5-2.7 vs mean 2.4, SD 2.3; 95% CI 2.3-2.5; P<.001) and more moving average daily walking distance (mean 3.5, SD 1.3; 95% CI 3.4-3.6 vs mean 3.2, SD 0.8; 95% CI 3.1-3.3; P<.001). Moving average daily walking distances among intervention participants increased, which was also significantly higher than that of the control group (regression slope=0.0046 vs 0.0017; P<.001). Participants in the intervention group reported a growing sense of accountability and motivation. One barrier was completing weekly monitoring of patient-reported outcome surveys, which focused on symptoms and physical function and did not always align with participants’ goals.

CONCLUSIONS: The HealthScore telehealth coaching program improved physical activity levels among cancer survivors and enhanced motivation and accountability. These findings support the integration of telehealth-based health coaching into posttreatment care, promoting healthier lifestyles and improved quality of life for cancer survivors.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04923997; https://clinicaltrials.gov/study/NCT04923997.

PMID:41538790 | DOI:10.2196/78968

JMIR Form Res. 2026 Jan 15;10:e68698. doi: 10.2196/68698.

ABSTRACT

BACKGROUND: University students show a high prevalence of diverse mental health problems, requiring adaptable interventions to assist them in improving their mental health.

OBJECTIVE: This study aimed to evaluate the feasibility of transdiagnostic internet-delivered cognitive behavioral therapy (ICBT) for anxiety and depression in preparation for a randomized controlled trial. ICBT incorporated 2 innovative approaches to increase precision: user-steered content personalization and within-treatment adaptive modification based on early symptom trajectory.

METHODS: This single-group, open-label study was conducted online in Sweden in the autumn of 2021, recruiting from students who had completed the World Health Organization (WHO) World Mental Health International College Student (WMH-ICS) mental health survey. Participants were eligible if they scored 5-19 on the Patient Health Questionnaire-9 (PHQ-9), or ≥5 on the Generalized Anxiety Disorder-7 (GAD-7), or both. Participants completed an 8-week ICBT program with therapist support. They initially personalized their program by selecting a primary problem orientation, anxiety or depression, and choosing additional elective modules, and could consult their therapist regarding these choices. At midtreatment, stepped care was piloted, in which participants without symptom improvement were randomized to adaptive enhancement of therapist support or to continue treatment as before. The main feasibility outcomes included data on reach and uptake, intervention acceptability, stepped care procedures, and assessment retention up to 6 months. The GAD-7 and PHQ-9 were the primary outcome measures, with changes in scores calculated using mixed effects models.

RESULTS: Of 749 invited students, 55 (7%) completed the study screening, and 28 (4%) were included. The GAD-7 baseline score was 9.5 (SD 4.4), and the PHQ-9 baseline score was 11.2 (SD 5.2). Participants opened 6.2 (SD 2.2) out of the 8 treatment modules. The user-directed personalization yielded 27 unique treatment configurations across 28 participants. At week 4, 16/27 (59%) participants remaining in treatment were randomized in the stepped care procedure. Ratings on self-report measures showed acceptable to good therapeutic alliance and treatment satisfaction. Eleven participants reported increased stress associated with the treatment. Reductions in depression and anxiety symptoms were observed at postmeasurement and 6 months follow-up, with 43% attrition at those times.

CONCLUSIONS: This pioneering study of personalized ICBT with adaptive change among university students demonstrated the overall feasibility of the treatment. To enhance the design of a future definitive trial, modifications are necessary to mitigate assessment attrition and reduce treatment-related stress.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05509660; https://clinicaltrials.gov/study/NCT05509660.

PMID:41538789 | DOI:10.2196/68698

Ann Plast Surg. 2026 Jan 16. doi: 10.1097/SAP.0000000000004627. Online ahead of print.

ABSTRACT

BACKGROUND: High-voltage electrical burns of the extremities often result in deep tissue destruction with exposure of vital structures, necessitating free flap reconstruction. However, the optimal timing for reconstruction remains uncertain, particularly in the presence of evolving tissue viability.

METHODS: This retrospective study included 23 patients with full-thickness high-voltage electrical burns involving the extremities who underwent free flap reconstruction. Patients were divided into two groups based on timing of flap coverage: early (<21 days) and delayed (>21 days, after at least 2 debridements). Outcomes assessed included flap survival, complications, reexploration rate, operative time, and hospital stay.

RESULTS: The cohort was predominantly male (male-to-female ratio of 10:1) with an age range of 15 to 60 years. The upper limb was involved in 16 patients; and the lower limb, in 7. The overall flap survival rate was 87% (20/23). Flap failure occurred in 1 of 6 early cases and 2 of 17 delayed cases (P = 1.00). Complications were more common in the early group (66.7%) compared to the delayed group (47.1%) but were not statistically significant (P = 0.34). Four flaps required reexploration, with one successfully salvaged. Operative time and hospital stay were slightly longer in the delayed group but did not reach statistical significance.

CONCLUSION: Free flap reconstruction remains a reliable option for limb salvage in high-voltage electrical burns. A biologically timed approach-delaying reconstruction until tissue demarcation and vascular stability-may minimize complications while maintaining high flap survival rates.

PMID:41538784 | DOI:10.1097/SAP.0000000000004627

J Comput Chem. 2026 Jan 15;47(2):e70308. doi: 10.1002/jcc.70308.

ABSTRACT

Large language models (LLMs) demonstrate strong performance in natural language tasks, but their capacity for genuine in-context learning (ICL) in scientific regression remains unclear. We systematically assessed seven LLMs on molecular property prediction using a controlled framework of 56 transformed tasks that isolate shortcut learning and are designed to induce functional out-of-distribution (OOD) behavior. LLMs performed nearly perfectly on raw molecular weight prediction via shortcut cues but deteriorated under nonlinear transformations, whereas machine learning (ML) baselines showed greater robustness, yielding a performance crossover. Meta-analysis revealed that distributional descriptors and structure-activity landscape indices (SALI) predict task favorability, providing a framework for selecting between LLM- and ML-based approaches in chemistry.

PMID:41538780 | DOI:10.1002/jcc.70308

J Invasive Cardiol. 2026 Jan 8. doi: 10.25270/jic/25.00171. Online ahead of print.

ABSTRACT

OBJECTIVES: Transfemoral (TF) access for transcatheter aortic valve replacement (TAVR) may be challenging in patients with peripheral arterial disease (PAD). Alternative access through intra- and extrathoracic approaches can be performed. Recently, a facilitated TF access strategy, which involves the use of intravascular lithotripsy to optimize the iliofemoral arteries prior to TAVR, has been utilized. The aim of this study was to evaluate early outcomes of facilitated TF access compared to alternative access in patients with severe PAD.

METHODS: Patients with severe PAD who underwent TAVR from 2021 to 2023 were included in the study and were divided into 2 groups: facilitated and alternative access. The primary endpoint was a composite of mortality, stroke, and vascular complications. Mortality was evaluated in-hospital and at 1-month follow-up.

RESULTS: Of 150 TAVR patients with severe PAD, 24 underwent facilitated access. Baseline characteristics including age, Society of Thoracic Surgeons score, and mean gradients were similar between the 2 groups. The most common alternative access was transsubclavian, followed by transcarotid. Primary outcomes were numerically higher in the alternative access group (14% vs 8%); however, this did not reach statistical significance (P = .49). General anesthesia use and postoperative length of stay were higher in the alternative access group. Postoperative and 1-month mortalities were similar between the 2 groups.

CONCLUSIONS: Although the primary endpoint did not reach statistical significance, the numerical trend toward better outcomes in the facilitated TAVR group indicates a potential advantage. Large-scale prospective studies are required to determine the appropriate access strategy for TAVR in patients with severe PAD.

PMID:41538775 | DOI:10.25270/jic/25.00171

Dermatol Surg. 2026 Jan 14. doi: 10.1097/DSS.0000000000004987. Online ahead of print.

ABSTRACT

BACKGROUND: Patient satisfaction with Mohs micrographic surgery is dependent on multiple clinical and surgical factors. This study implements a novel survey to assess patient satisfaction in multiple domains.

OBJECTIVE: (1) To assess whether satisfaction changes over time and (2) to evaluate predictors of patient satisfaction in multiple satisfaction domains.

MATERIALS AND METHODS: The Oxford Skin Cancer Treatment Scale (OxSCanTr) assesses patient satisfaction with scar aesthetics, treatment choice, surgical experience, and postoperative concerns. Surveys were completed immediately after surgery and at 1 week and 4 weeks postoperatively. Clinical and demographic data were collected. Statistical analysis included repeated-measures analysis of variance, univariate, and multivariate repeated-measures linear regression.

RESULTS: Satisfaction does not vary significantly over time. Diabetes, immunosuppression, and linear closure methods are associated with higher total satisfaction. Linear closure method predicts higher total, aesthetic outcome, and treatment experience satisfaction. Patient age, number of Mohs stages, noncutaneous cancer history, tumor location, skin cancer history, postoperative defect size, and absorbable top sutures predict patient satisfaction in at least one domain.

CONCLUSION: This study increases awareness of the clinical and surgical factors that contribute to patient satisfaction with Mohs procedures, which can help to advance patient-centered care.

PMID:41538767 | DOI:10.1097/DSS.0000000000004987