Category: Nevin Manimala

Int J Inj Contr Saf Promot. 2026 Feb 27:1-9. doi: 10.1080/17457300.2026.2635100. Online ahead of print.

ABSTRACT

Ghana is losing too many lives on the road, and the numbers continue to rise. This study examined road traffic fatalities in Ghana from 1991 to 2024, identified their major causes and compared Ghana’s situation with that of selected African countries. Data were obtained from credible sources, including the National Road Safety Authority, the World Health Organisation, the Ghana Highway Authority and relevant local studies. The findings show that more than 46,000 people died in road crashes between 1991 and 2018, with an additional 2,494 deaths recorded in 2024 alone. The leading causes were poor road infrastructure, driver error and vehicle defects. Comparative analysis revealed that Ghana’s road fatality rate is higher than that of Rwanda and Nigeria, despite Ghana having a smaller vehicle population. Using a statistical projection based on historical trends, the study indicates that Ghana could record more than 2,800 road deaths in a single year by 2030 if current conditions persist. This trajectory suggests that the country is unlikely to achieve the Sustainable Development Goal target of halving road traffic deaths. These findings highlight a crisis that has become normalised in everyday life, where road travel is often perceived as a gamble. Urgent and coordinated action is therefore required, including improved road infrastructure, expansion of dual carriageways, stricter enforcement of traffic regulations and sustained public education. Road safety in Ghana has become a national public health and development priority rather than a transport issue alone.

PMID:41758544 | DOI:10.1080/17457300.2026.2635100

Soft Matter. 2026 Feb 27. doi: 10.1039/d5sm01268f. Online ahead of print.

ABSTRACT

This work presents a compact, general model that predicts static contact angles and upper bounds on contact angle hysteresis for random or periodic local surface topography by accounting for arbitrary fractions of localized air entrapment and liquid infiltration within micro/nanoscale topographic features adjacent to the contact line. The proposed model recovers classical wetting limits (Wenzel, Cassie-Baxter, and hemiwicking), accounts for intermediate states (e.g., impregnating Cassie), and highlights a fourth limiting state with potential realizability and practical implications: a bulk Cassie state with an ambient liquid film, termed the inverse Wenzel state. The model predictions provide actionable guidance for the rational design of micro- and nanostructured surfaces to modulate contact angle hysteresis, under real-world operating conditions that are often uncontrolled and unpredictable due to local variations of the surface topography, fouling or contamination at the liquid-solid and liquid-vapor interfaces, chemical aging, kinetic constraints, and fluctuations of the ambient relative humidity and temperature.

PMID:41758538 | DOI:10.1039/d5sm01268f

JAMA Health Forum. 2026 Feb 6;7(2):e256872. doi: 10.1001/jamahealthforum.2025.6872.

ABSTRACT

IMPORTANCE: In 2020, all US states adopted the Families First Coronavirus Response Act Medicaid continuous coverage requirement (CCR), which prevented disenrollment from Medicaid. This policy effectively extended pregnancy-related Medicaid eligibility beyond the previous end date of 60 days post partum.

OBJECTIVE: To determine whether the CCR was associated with a change in postpartum hospitalization rates for mothers covered by Medicaid during their delivery.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted from December 2023 to March 2025 at all nonfederal acute care hospitals in 20 states using data from the Healthcare Cost and Utilization Project’s State Inpatient Databases from 2018 through 2021. Participants included mothers aged 18 to 55 years who had Medicaid-paid deliveries (based on the primary expected payer) from January 2018 to June 2021; they were followed up for 180 days post partum.

EXPOSURES: State-level postpartum uninsured rate among mothers with Medicaid-paid deliveries that occurred from 2018 to 2019 (before the CCR was implemented in 2020). Residency in states with an uninsured rate above the median was considered to be high exposure (ie, a greater share of the state population had the potential to benefit from the CCR) and residency in states with a preperiod uninsured rate below the median was considered low exposure.

MAIN OUTCOMES AND MEASURES: Probability of a mother being hospitalized 1 to 60 days post partum (covered under previous Medicaid eligibility rules) and 61 to 180 days post partum (newly covered under the CCR).

RESULTS: A total of 2 024 214 mothers (mean age, 27.5 [95% CI, 27.5-27.5] years) with Medicaid-paid deliveries were identified. The sample included 550 881 deliveries by Hispanic mothers (27.2%), 490 586 deliveries by non-Hispanic Black mothers (24.2%), 744 945 deliveries by non-Hispanic White mothers (36.8%), 200 639 deliveries by mothers of other races and ethnicities (9.9%), and 37 163 deliveries by mothers with missing race and ethnicity data (1.8%). Among the full sample, 931 452 mothers (mean age, 27.1 [95% CI, 27.71-27.2] years) resided in high-exposure states and 1 092 762 mothers (mean age, 27.8 [95% CI, 27.8-27.8] years) resided in low-exposure states. In adjusted difference-in-differences models, the rate of hospitalization per 1000 Medicaid-paid deliveries at 61 to 180 days post partum decreased (adjusted β coefficient, -1.4; 95% CI, -2.5 to -0.3) in high-exposure states compared with low-exposure states, a 10.9% decrease relative to the preperiod mean (12.9; 95% CI, 12.6 to 13.2) in high-exposure states. The analogous estimate for the hospitalization rates 1 to 60 days post partum was not statistically significant (-0.7 [95% CI, -2.0 to 0.5] per 1000 Medicaid-paid deliveries).

CONCLUSIONS AND RELEVANCE: Findings of this study suggest that residency in high-exposure states was associated with a reduction in hospitalizations for mothers 61 to 180 days post partum (the period newly covered by extended Medicaid coverage). Extended Medicaid coverage may help to improve postpartum health and reduce adverse events among mothers with low income.

PMID:41758525 | DOI:10.1001/jamahealthforum.2025.6872

JAMA Netw Open. 2026 Feb 2;9(2):e2559863. doi: 10.1001/jamanetworkopen.2025.59863.

ABSTRACT

IMPORTANCE: Overdose prevention centers (OPCs) are interventions to reduce overdose mortality and support health care engagement. In the US, concerns have been raised that OPCs may be associated with reduced economic activity in their surrounding neighborhoods.

OBJECTIVE: To evaluate changes in the local economic activity in New York City (NYC), measured by neighborhood-level foot traffic and consumer spending, following the opening of the first 2 publicly recognized OPCs in the US.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used anonymized mobility and spending data from June 1, 2021, to June 13, 2022, for the areas surrounding the East Harlem and Washington Heights OPCs in NYC. These neighborhoods were defined using 5-minute and 10-minute walking buffers and Business Improvement Districts (BIDs). Synthetic control donors included walking buffers and BIDs around syringe service programs without OPCs and opioid treatment programs that were operational as of OPCs’ opening. Analyses were conducted from February to July 2025.

EXPOSURES: Opening of the 2 NYC OPCs on November 30, 2021.

MAIN OUTCOMES AND MEASURES: Primary outcomes were foot traffic and in-person consumer spending within 10-minute walking buffers. Secondary analyses considered 5-minute walking buffers and BIDs. Augmented synthetic control models were adjusted for neighborhood-level demographic and socioeconomic features, with fit assessed using root mean squared error before OPC opening. Permutation tests and conformal inference were used to assess significance.

RESULTS: A total of 27 biweekly observations (13 in pre-OPC and 14 in post-OPC periods) were analyzed. The 10-minute walking buffer analyses captured 1259 consumer spending sites and 7816 foot traffic sites across 2 treated buffers and 56 donor buffers. In East Harlem, the average treatment effect on the treated (ATT) estimate (SE) was -$21.96 ($40.53) for consumer spending (P = .16) and 1.28 (5.40) visits for foot traffic (P = .19). In Washington Heights, ATT (SE) estimates were $14.94 ($37.38) for consumer spending (P = .13) and 0.44 (3.54) visits for foot traffic (P = .97). Secondary analyses produced consistent results. No statistically significant results were observed at any post-OPC time point.

CONCLUSIONS AND RELEVANCE: This cohort study found that OPC opening was not associated with significant changes in local economic activity. Given the absence of observed economic harms, policy debates should instead focus on the public health implications of OPCs.

PMID:41758519 | DOI:10.1001/jamanetworkopen.2025.59863

JAMA Netw Open. 2026 Feb 2;9(2):e2560084. doi: 10.1001/jamanetworkopen.2025.60084.

ABSTRACT

IMPORTANCE: In an effort to increase access to care, the US Department of Veterans Affairs (VA) has created 2 additional pathways for veterans to receive mental health (MH) services: regional VA Clinical Resource Hubs (CRHs) and VA-purchased community care (CC). Previous studies have found that veterans rate their satisfaction with VA MH care, including via CRHs, higher than CC. It is unclear whether increased CRH use decreases referrals to CC.

OBJECTIVE: To determine whether clinics with higher CRH utilization have fewer CC referrals or, alternatively, whether clinics with local care shortages rely on both CRH and CC at similar levels to ensure adequate access to MH care.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study included all veterans with at least 1 outpatient MH encounter between 2018 and 2019 in 1149 MH clinics within the VA. The study evaluated changes in CC referral rates at clinics with and without CRH visits between baseline and post-CRH implementation (October 1, 2017, through September 30, 2023). In addition, CC referral rates at clinics with higher use of CRH were compared with clinics with lower CRH utilization. Data were analyzed from August 20, 2024, to July 25, 2025.

EXPOSURES: Clinics were classified based on whether they had any CRH utilization, as well as whether their per-patient rate of CRH visits fell in the top 25% (high penetration) or bottom 25% (low penetration).

MAIN OUTCOMES AND MEASURES: The main outcome was the number of CC referrals per 1000 patients. Difference-in-differences (DID) analyses were used.

RESULTS: The sample included 1 120 250 patients (mean [SD] age, 60.04 [15.38] years; 15.99% female). Clinics with any CRH utilization showed a slight but statistically significant increase in CC referrals in the post-CRH implementation period compared with clinics with no CRH utilization (DID, 0.525; 95% CI, 0.181-0.868; P = .003). However, clinics with high penetration of CRH had fewer CC referrals per month compared with low-penetration clinics at the end of the CRH implementation period (DID, -20.00 referrals; 95% CI, -21.90 to -18.20; P < .001).

CONCLUSIONS AND RELEVANCE: In this cohort study of VA MH clinics, successful CRH implementation was associated with fewer CC referrals, suggesting that clinics with higher CRH utilization were less reliant on VA-purchased CC. Results underscore the importance of developing strong CRH infrastructures to ensure veteran access to high-quality MH care.

PMID:41758516 | DOI:10.1001/jamanetworkopen.2025.60084

Ann Biomed Eng. 2026 Feb 27. doi: 10.1007/s10439-026-04048-2. Online ahead of print.

NO ABSTRACT

PMID:41758489 | DOI:10.1007/s10439-026-04048-2

Metabolomics. 2026 Feb 27;22(2):29. doi: 10.1007/s11306-026-02401-z.

ABSTRACT

BACKGROUND: Metabolomic data offers insights into disease mechanisms, diagnostics, and therapeutic targets by analyzing metabolic profiles. In analyzing these profiles, traditional bioinformatic and statistical approaches, while valuable, often struggle to process high-dimensional and nonlinear metabolic data, lacking the sensitivity and adaptability that artificial intelligence (AI) and machine learning (ML) techniques provide. The integration of AI/ML has greatly enhanced the metabolomics field, enabling biomarker identification, disease prediction, and classification of metabolic patterns at an unprecedented level.

AIM OF REVIEW: This study analyses and compares the scientific goals, methodologies, datasets, and sources of AI/ML approaches applied to metabolomic data, as well as assessing their implications in precision medicine. We systematically reviewed recent advancements in AI/ML applications to metabolomic data, focusing on peer-reviewed research indexed in PubMed. Significant number of studies were analyzed, covering diseases such as cancer, cardiovascular diseases, and diabetes. Our results showed that the most used AI/ML techniques were SVM, RF, Gradient Boosting, and Logistic Regression, highlighting their effectiveness in processing complex metabolic data. Despite these advancements, key challenges persist in AI/ML applications to metabolomics data, including small cohort sizes, data heterogeneity, and the need for improved model interpretability, and these challenges must be considered for future use.

KEY SCIENTIFIC CONCEPTS OF REVIEW: Ultimately, our findings underscore the transformative potential of AI/ML in metabolomics and its critical role in advancing precision medicine by uncovering novel metabolic pathways, improving treatment strategies, and enabling the earlier diagnosis of diseases through predictive metabolic profiling.

PMID:41758481 | DOI:10.1007/s11306-026-02401-z

J Cancer Res Clin Oncol. 2026 Feb 27;152(2):52. doi: 10.1007/s00432-026-06432-w.

ABSTRACT

OBJECTIVES: Multidisciplinary tumor boards (MDTs) are critical for the personalized management of soft tissue sarcomas (STS), but they are limited by time, costs, and resource demands. With recent advances in large language models (LLMs) like ChatGPT, there is growing interest in evaluating their potential role in augmenting MDT workflows. This study aimed to assess the clinical performance of ChatGPT-4o in real-world STS cases using predefined evaluation criteria, comparing its treatment suggestions with expert MDT decisions.

MATERIALS AND METHODS: This retrospective study included 152 patients presented to the multidisciplinary sarcoma tumor board. ChatGPT-4o was prompted to generate guideline-based treatment recommendations based on anonymized tumor board registration letters. Outputs were scored by blinded expert reviewers using a five-domain framework: diagnostic modalities, therapeutic modalities, treatment sequencing/timing, chemotherapy regimen, and clinical contextualization. Descriptive statistics and non-parametric ANOVA with post hoc tests assessed performance, including subgroup analysis by sarcoma subtype.

RESULTS: ChatGPT-4o scores were significantly lower than the maximum achievable value of 1.0 across all five criteria (all p < 0.0001). Among individual domains, clinical contextualization significantly outperformed all other criteria in pairwise comparisons (all p < 0.05). No significant performance differences were observed across sarcoma subtypes (H = 19.74, p = 0.138).

CONCLUSIONS: ChatGPT-4o demonstrated substantial expert-rated performance in generating tumor board recommendations for soft tissue sarcoma cases, particularly excelling in personalized contextualization. Discrepancies in treatment sequencing and chemotherapy selection highlight the need for expert oversight. These findings support the feasibility of LLM integration into oncology workflows, warranting further refinement toward safe, supportive clinical use.

PMID:41758476 | DOI:10.1007/s00432-026-06432-w

Environ Sci Pollut Res Int. 2026 Feb 27. doi: 10.1007/s11356-026-37546-w. Online ahead of print.

ABSTRACT

Air pollution remains a persistent environmental and public health concern in urban regions. This study presents a 22-year analysis (2001-2022) of coarse particulate matter (PM₁₀) concentrations across 15 monitoring stations in the Porto Metropolitan Area (PMA), Portugal. The stations, pre-classified by national authorities as traffic, background-urban, background-suburban, or industrial, were used to assess long-term temporal trends and spatial variability. Annual mean PM₁₀ concentrations were calculated and linear regression was applied to evaluate trends. Differences between station types were tested using statistical analysis. The results revealed consistent decline in PM₁₀ levels from the early 2000s to the mid-2010s, followed by stagnation or increases at several stations in the final years of the series. While higher concentrations were historically observed at traffic and industrial sites, no statistically significant differences in annual mean PM₁₀ concentrations were found between stations of different classifications or within classifications, even when comparing distinct time periods. This homogeneity suggests widespread regional exposure, likely driven by shared emission sources, atmospheric transport, and urban development patterns across the PMA. When compared to World Health Organization (WHO) air quality guidelines, exceedances were frequent and persistent. From 2001 to 2011, nearly all stations with valid data exceeded the 2005 guideline of 20 µg/m³. Between 2012 and 2020, the exceedances gradually decreased, although several stations still surpassed the guideline. However, under the 2021 WHO guideline (15 µg/m³), all stations with valid data for 2021 and 2022 again exceeded the guideline. These findings highlight the need for integrated, long-term air quality policies. Clinical trial number: Not applicable.

PMID:41758433 | DOI:10.1007/s11356-026-37546-w

Int J Lang Commun Disord. 2026 Mar-Apr;61(2):e70214. doi: 10.1111/1460-6984.70214.

ABSTRACT

BACKGROUND: Speech and language therapists (SLTs) working in dysphagia care regularly navigate complex ethical dilemmas involving clinical risk, patient autonomy and cultural considerations. While ethical principles are well-recognized in the field, consolidated evidence mapping how these principles and ethical reasoning components have been represented in the literature over time remains limited. This review offers a comprehensive synthesis of ethical challenges in dysphagia management across decades and contexts, uniquely structured using Rest’s Four-Component Model of ethical behaviour.

METHOD: This scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. A systematic search of databases from 1990 to 2024 identified 22 peer-reviewed articles. Data were analysed using descriptive statistics and thematic content analysis, with ethical principles and components classified according to Beauchamp and Childress and Rest’s Four-Component Model.

MAIN CONTRIBUTIONS: Analysis revealed evolving ethical priorities within interdisciplinary roles and responsibilities of SLTs. These ethical priorities suggest the importance of ethical decision- making and person-centred care in dysphagia management, specifically foregrounded by the focus on the principles of autonomy and informed consent and the components of moral judgement and sensitivity.

CONCLUSION: The findings underscore the dynamic and complex ethical landscape of dysphagia management, emphasizing the need for cultural awareness and respect, shared decision-making and evidence-based practice. To navigate these challenges, SLTs require continuous education, interdisciplinary collaboration and adaptable ethical frameworks. This review provides a comprehensive synthesis of ethical challenges and considerations through longitudinal, theory-informed analyses using Rest’s Four Component model. This model is useful in breaking down complexity into understandable psychological steps, identifying gaps, guiding education and culture by fostering genuine ethical conduct beyond intellectual understanding across decades, geographic regions and professional roles in SLT.

WHAT THIS PAPER ADDS: What is already known on this subject The field of dysphagia often places SLTs at the intersection of clinical care, patient preferences and ethical decision-making, making the consideration of ethical principles an integral part of their practice. What this paper adds to existing knowledge A comprehensive synthesis of ethical challenges and considerations in dysphagia spanning multiple decades, geographic regions and methodological approaches using Rest’s Four-Component Model to classify ethical components. What are the potential or actual clinical implications of this work? Cultural awareness and shared decision making are vital aspects in dysphagia management, with the use of telepractice raising ethical concerns related to equity, privacy and informed consent.

PMID:41758432 | DOI:10.1111/1460-6984.70214