Category: Nevin Manimala

J Clin Nurs. 2026 Apr 8. doi: 10.1111/jocn.70310. Online ahead of print.

ABSTRACT

AIM: To evaluate whether simulation-based I-PASS handoff training improves ICU nurses’ knowledge, perceptions of handoff communication and safety attitudes.

BACKGROUND: Effective handoff communication is crucial for ensuring patient safety and reducing errors. However, simulation-based training (SBT) with structured protocols, such as I-PASS, is rarely used in Egyptian nursing education, highlighting a gap.

DESIGN: A quasi-experimental design was employed.

METHODS: A convenience sample of 57 ICU nurses was studied from June to December 2023. Data were collected using the I-PASS Handoff Knowledge Questionnaire, Perception of Handoff Communication Tool and Patient Safety Questionnaire. Nurses completed baseline assessments, participated in two simulation-based I-PASS scenarios and repeated assessments post-intervention. Statistical analyses examined the training’s impact and its relationships with participants’ socio-demographic characteristics.

RESULTS: Significant improvements were observed in I-PASS knowledge, perceptions of handoff communication and safety attitudes (all p < 0.001). Nursing qualifications and place of residence have shown a significant correlation with perceptions of handoff communication and safety attitudes (p < 0.05).

CONCLUSION: Simulation-based I-PASS handoff training significantly enhances ICU nurses’ knowledge, perceptions of handoff communication and safety attitudes. Targeted, context-sensitive educational interventions are necessary to strengthen handoff practices and improve patient safety within the Egyptian healthcare system.

RELEVANCE TO CLINICAL PRACTICE: Structured simulation-based training, such as I-PASS, can be effectively integrated into nursing education to standardise handoff communication and improve patient safety outcomes in intensive care settings.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41952038 | DOI:10.1111/jocn.70310

Int J Dent Hyg. 2026 Apr 8. doi: 10.1111/idh.70060. Online ahead of print.

ABSTRACT

AIM: To analyse and compare the attitude of dental hygienists trained in Portugal (DH-Portugal) and other European countries (DH-Other Countries) regarding the treatment of people with disabilities (PwD).

METHODS: A cross-sectional descriptive study applied an online adapted questionnaire of the ‘Dental Student’s Attitudes towards the Handicapped Scale’ that was sent to all dental hygiene associations members of the European Dental Hygienists Federation. The questionnaire collected sociodemographic data, educational experience and instructor perception (Factor 1) and interpersonal attitudes and future interactions with PwD (Factor 2). Statistical analysis included the Independent t-test, Kruskal-Wallis and Mann-Whitney tests with a significance level of 5%.

RESULTS: A total of 124 dental hygienists answered to the questionnaire: 66 from Portugal and 58 from other countries. In factor 1, the mean total attitude score for all participants was 4.00 (±0.60), with DH-Portugal scoring 4.25 (±0.44) and DH-other countries scoring 3.72 (±0.64) (p = 0.001). For factor 2, the mean score was 4.15 (±0.50) [2.62-5.00], with DH-Portugal scoring 4.23 (±0.44) and DH-other countries scoring 4.06 (±0.55) (p = 0.063). Attitudes towards PwD were not different regarding years of experience and number of PwD in a 6-month period, However involvement in community activities was associated with higher attitude scores (p = 0.001).

CONCLUSION: Although there is global positive attitude towards treatment of PwD, DH-Portugal demonstrated a more positive attitude compared to DH-Other Countries, with better educational experience and greater satisfaction with the training received.

PMID:41952033 | DOI:10.1111/idh.70060

Behav Res Methods. 2026 Apr 8;58(4):107. doi: 10.3758/s13428-026-02968-4.

ABSTRACT

Testing goodness-of-fit and multi-group nested models in confirmatory factor analysis under non-normality is foundational in psychometrics and related fields. Recently, a penalized eigenvalue block averaging (pEBA) procedure was proposed for testing goodness-of-fit, showing promise in a restricted type I error control simulation study. In this study, we extend the simulation conditions to higher dimensions for latent and observed vectors and evaluate type I error control and power for many pEBA variants and traditional test statistics. All statistics are evaluated in four versions, by crossing the base statistic (ML or Browne’s RLS), and whether the asymptotic covariance matrix estimator was bias-corrected or not. We develop pEBA methods in the new setting of nested model comparison, accompanied by extensive Monte Carlo evaluation of their performance in weak invariance testing, including type I error control and power. The best-performing procedure for goodness-of-fit testing was pEBA with four blocks, based on the RLS statistic, using the asymptotic covariance matrix estimator without bias correction. For measurement invariance, pEBA with singleton blocks, using the standard ML statistic and the unbiased estimator for the asymptotic covariance matrix, performed best. The pEBA procedures are available in the newly developed R package semTests.

PMID:41952013 | DOI:10.3758/s13428-026-02968-4

Geroscience. 2026 Apr 8. doi: 10.1007/s11357-026-02225-8. Online ahead of print.

ABSTRACT

Albuminuria is traditionally defined using fixed urinary albumin-creatinine ratio (UACR) thresholds, although cardiovascular disease (CVD) risk has been reported to increase continuously across the UACR spectrum. Whether these associations are present in healthy older adults and differ by sex remains unclear. We examined sex-specific associations between low-level UACR, mortality, and cardiovascular outcomes in older adults with preserved kidney function. From the ASPirin in Reducing Events in the Elderly (ASPREE) study, we included 5396 males and 6305 females aged ≥ 70 years with baseline UACR and eGFR ≥ 60 mL/min/1.73 m²). Sex-stratified Cox models examined associations between UACR quintiles (Q) and mortality, CVD, major adverse cardiovascular events (MACE), and stroke, using Q1 as reference. Over a median follow-up of 8.3-8.6 years, increasing UACR was associated with progressively higher risk of all-cause mortality in both sexes, despite most values being below the guideline thresholds. Mortality risk reached statistical significance for males from Q4 (HR 1.45; 95% CI 1.18-1.77) and females from Q2 (HR 1.33; 95% CI 1.04-1.71). Males also had a statistically significant increase in CVD from Q4 (HR 1.32; 95% CI 1.03-1.70) and MACE and stroke in Q5 (HR 1.61; 95% CI 1.25-2.07 and HR 1.96; 95%CI 1.38-1.78). Despite an increasing trend in females, adverse cardiovascular outcomes did not reach significance. UACR levels below guideline thresholds were associated with all-cause mortality in both sexes, with increased cardiovascular disease predominately observed in men. These findings support a continuous relationship between UACR and risk and suggest that even low-level albuminuria may have prognostic significance in healthy older adults.

PMID:41952007 | DOI:10.1007/s11357-026-02225-8

J Clin Sleep Med. 2026 Apr 8;22(1):49. doi: 10.1007/s44470-026-00065-z.

ABSTRACT

PURPOSE: This study examined the association of insomnia, sleep apnea, and comorbid insomnia and sleep apnea (COMISA) with all-cause mortality in a large Veteran sleep clinic cohort.

METHODS: We retrospectively identified Veterans with insomnia and/or SA using ICD-9/10 codes, requiring two diagnoses within 13 months (≥ 30 days apart). Insomnia cases also required relevant prescriptions and/or cognitive behavioral therapy for insomnia (CBT-I); SA cases required positive airway pressure prescriptions within three years. Patients were classified as insomnia only (INS), SA only, or COMISA. Adjusted odds ratios (aOR) for mortality were estimated using SA as the reference. Model 1 adjusted for age, sex, race, ethnicity, and Charlson Comorbidity Index (CCI); Model 2 additionally adjusted for trazodone and quetiapine; Model 3 additionally adjusted for benzodiazepines and benzodiazepine receptor agonists. Model 4 included all Model 3 covariates plus CBT-I.

RESULTS: Among the 1,720,090 patients, 47.6% had SA (mean age 56.3 ± 13.7; 93.3% male; 69% White; 26.2% with CCI > 2), 41.1% had INS (mean age 57.0 ± 16.8; 87.1% male; 70.3% White; 25.4% with CCI > 2), and 11.2% had COMISA (mean age 51.9 ± 13.2; 89.4% male; 66.7% White; 19.6% with CCI > 2). Compared with SA, unadjusted ORs for mortality were 1.75 (95% CI: 1.73-1.76) for INS and 0.68 (95% CI: 0.67-0.69) for COMISA. Fully adjusted aORs were 1.51 (95% CI: 1.49-1.52) for INS and 0.79 (95% CI: 0.78-0.80) for COMISA.

CONCLUSION: Among the Veterans referred to sleep clinics, insomnia alone was associated with the highest mortality, followed by SA, and the lowest in COMISA. These findings contrast with published studies and need to be seen considering the limitations of our approach, including the possibility that lack of a pre-specified hypothesis increases the risk of spurious findings.

STUDY RATIONALE: Insomnia and sleep apnea commonly coexist as comorbid insomnia and sleep apnea (COMISA), which has been linked to increased mortality in population-based studies. Evidence from clinical cohorts, particularly among Veterans, remains limited.

STUDY IMPACT: In this exploratory, hypothesis-generating large cohort of Veterans referred to sleep clinics, insomnia alone was associated with the highest mortality, followed by sleep apnea, and the lowest in COMISA. These results contrast with prior population studies and should be interpreted cautiously given study limitations (including possible chance findings without a pre-specified hypothesis), warranting confirmation.

PMID:41952004 | DOI:10.1007/s44470-026-00065-z

J Cancer Educ. 2026 Apr 9. doi: 10.1007/s13187-026-02872-7. Online ahead of print.

ABSTRACT

Use of integrative oncology (IO) has increased substantially, with a majority of cancer patients reporting use of integrative therapies alongside conventional treatment. Despite growing patient demand and expansion of integrative services at cancer centers, structured educational pathways for oncology providers remain limited. This national needs assessment evaluated interest in IO training and identified perceived barriers and priorities for curriculum development. An 18-question survey was distributed nationally to hematology/oncology, radiation oncology, and palliative care program directors, physicians, fellows, and internal medicine residents planning to enter these specialties. Programs were identified through the Accreditation Council for Graduate Medical Education (ACGME). Surveys were sent electronically with informed consent and distributed weekly for two 4-week sessions. Descriptive statistics were used to summarize responses. A total of 208 eligible participants responded to survey. The majority (71.6%) considered IO valuable or essential, meanwhile expressing interest in formal education (64.2%) in IO education. Most respondents had little or no prior integrative medicine training (85.4%). Program directors endorsed the training at valuable (50%) or essential (13.3%). Key barriers included lack of curriculum, limited faculty expertise, inadequate funding, and time constraints. Participants preferred certificate programs (48%) or fellowship distinction tracks (44%) over a standalone IO fellowship. This national needs assessment demonstrates a national training gap and support the development of structured, scalable educational pathways in integrative oncology.

PMID:41951997 | DOI:10.1007/s13187-026-02872-7

Saudi Dent J. 2026 Apr 8;38(4):45. doi: 10.1007/s44445-026-00166-8.

ABSTRACT

The color degradation of ocular prostheses is significantly affected by exposure to ultraviolet (UV) light over time. As a result, the prosthesis requires frequent replacement, ultimately increases the financial burden of rehabilitation on the patient. This study aimed to determine the optimal bisoctrizole percentage for ocular acrylic by assessing its effects on color stability after 300 h of artificial aging and on surface hardness. A total of 120 specimens were prepared from white heat-cure scleral acrylic and subdivided into two groups according to the conducted tests; color stability and surface hardness. Each of these groups were further subdivided into 6 groups with 10 specimens for each based on the weight percentages of bisoctrizole added; 0%, 0.5%, 1%, 1.5%, 2% and 2.5%. The color parameters were measured before and after artificial weathering using a portable digital colorimeter according to the CIE L*a*b* system. Shapiro-Wilk test was used to confirm normality of data. One-way ANOVA was used among the study groups followed by Tukey’s honestly significant difference (HSD) as a post hoc test (α = 0.05). All groups exhibited significant (p < 0.001) color change (ΔE > 0) after aging, with the control (0%) showing the highest ΔE. A progressive decrease in ΔE was observed with increasing bisoctrizole. Surface hardness was clinically comparable, though compared to the control, a statistically significant difference was found in Groups 1.5% and 2% (p < 0.001). Bisoctrizole had effectively preserved the color of scleral acrylic over time under UV light. Additionally, it had minimally affected the surface hardness of the material.

PMID:41951988 | DOI:10.1007/s44445-026-00166-8

Environ Monit Assess. 2026 Apr 9;198(5):422. doi: 10.1007/s10661-026-15294-1.

ABSTRACT

Heavy metal pollution in regional and global agricultural soils is an increasing concern, especially under the current context of frequent extreme climate events. In this study, we investigated the distribution characteristics of heavy metals in typical Chinese farmland soils under varying fertilization levels, precipitation intensities, and crop types. We employed a structural equation model (SEM) and random forest model (RFM) to elucidate the effects of precipitation, fertilizer application, soil properties, and other factors on the heavy metal content of farmland soils. Our findings demonstrated that level III fertilization posed the highest ecological risk of heavy metal contamination (ecological risk index (RI) = 219). Medium contamination risk was observed in areas with precipitation > 800 mm and precipitation of 400-800 mm (1 < pollution load index (PLI) ≤ 3). The RI (610) was 5.71 times higher in rice-wheat rotation areas than in areas with other crops. Geospatial, soil physicochemical properties, precipitation, and pesticides significantly impact heavy metal concentrations (p < 0.05). Furthermore, SEM and RFM have elucidated the distinct pathways through which diverse influencing factors affect soil heavy metal content, along with quantifying the magnitude of each contribution. Our results suggest that the escalation of precipitation (extreme and average precipitation) and the heightened intensity of human agricultural activities are exacerbating the deterioration of heavy metal contamination in agricultural soils. This research provides essential foundational data and significant references for the mitigation of heavy metal pollution in farmland soils.

PMID:41951982 | DOI:10.1007/s10661-026-15294-1

Support Care Cancer. 2026 Apr 9;34(5):413. doi: 10.1007/s00520-026-10643-9.

ABSTRACT

BACKGROUND: Cancer survivors often experience multidimensional functional limitations (FL) that can impact their overall health outcomes. This study primarily evaluated the associations of FL with all-cause and cancer-specific mortality, and secondarily with home care and emergency room use among US cancer survivors.

METHODS: Data from the 2004-2018 National Health Interview Survey (NHIS) were collected for this study. FL was defined as reporting difficulties in any of the 12 items across three dimensions: mobility, physical tasks and dexterity, and social and recreational engagement. The associations of FL with health outcomes were explored among 24,003 cancer survivors who were linked to the National Death Index (NDI) records through December 31, 2019. Multivariable Cox proportional hazard regression models, Fine and Gray regression models, and Logistic regression models were employed to estimate the associations between FL and all-cause mortality, cancer-specific mortality, home care, and emergency room use.

RESULTS: Cancer survivors reported significantly higher rates of FL compared to individuals without cancer across all FL items (all P < 0.001). FL was significantly associated with increased all-cause mortality (HR = 1.74, 95% CI = 1.59-1.91; P < 0.001), cancer-specific mortality (HR = 1.42, 95% CI = 1.27-1.58; P < 0.001), likelihood of requiring home care (OR = 4.05, 95% CI = 3.18-5.17; P < 0.001) and emergency room use (OR = 1.92, 95% CI = 1.75-2.11; P < 0.001). Similar results were found in the analyses for the three dimensions and the number of FL.

CONCLUSION: Three dimensions of FL were associated with increased mortality risk, home care, and emergency room use among cancer survivors. Targeted interventions to alleviate these limitations are essential for improving long-term outcomes.

PMID:41951973 | DOI:10.1007/s00520-026-10643-9

Nature. 2026 Apr;652(8109):379-386. doi: 10.1038/s41586-026-10260-w. Epub 2026 Apr 8.

ABSTRACT

Artificial light at night (ALAN) marks the global impact of humanity^1,2. Yet, our understanding of its true ebb and flow has been limited, often based on temporally aggregated satellite data that obscure finer dynamics. Here, using daily night-time satellite imagery³ and a continuous change detection approach^4,5, we created global maps of high-frequency ALAN dynamics (2014-2022). Our findings challenge the prevailing perspective that changes in light radiance are largely gradual and unidirectional. Instead, the nightlights of Earth are surprisingly dynamic, characterized by frequent and coexisting brightening and dimming. On average, each location experiencing change underwent 6.6 distinct shifts over the 9 years. Driven by this volatility, the cumulative area of total ALAN change comprised 2.05 million km² of abrupt changes and 19.04 million km² of gradual changes. Brightening contributed a radiance increase equivalent to 34% of the 2014 global baseline, whereas dimming offset this by 18%. Notably, both brightening and dimming have markedly intensified over the past decade. This evidence of increasing volatility in human night-time activity provides an important dynamic dimension for understanding urban evolution, energy transitions, policy impacts and ecological consequences of rapidly changing illuminated nights.

PMID:41951967 | DOI:10.1038/s41586-026-10260-w