Category: Nevin Manimala

Phys Rev Lett. 2026 Feb 27;136(8):081802. doi: 10.1103/rk6w-1pcl.

ABSTRACT

The first observation of single top quark production in association with a W and a Z boson in proton-proton collisions is reported. The analysis uses data at center-of-mass energies of 13 and 13.6 TeV recorded with the CMS detector at the CERN LHC, corresponding to a total integrated luminosity of 200 fb^{-1}. Events with three or four charged leptons, which can be electrons or muons, are selected. Advanced machine-learning algorithms and improved reconstruction methods, compared to an earlier analysis, result in an unprecedented sensitivity to tWZ production. The measured cross sections for tWZ production are 248±52 fb and 242±77 fb for sqrt[s]=13 and 13.6 TeV, respectively. The signal is established with a statistical significance of 5.8 standard deviations, with 3.5 expected, compared to the background-only hypothesis.

PMID:41824968 | DOI:10.1103/rk6w-1pcl

Comput Inform Nurs. 2026 Mar 13. doi: 10.1097/CIN.0000000000001515. Online ahead of print.

ABSTRACT

The purpose of this research was to determine the effect of virtual reality on patients undergoing total knee replacement on their anxiety level and vital signs. A total of 70 patients were randomly allocated into the virtual reality group (n = 35) and control group (n = 35). Patients in the virtual reality group were shown nature and landscape images with virtual reality for 1 hour during surgery. The routine intraoperative procedure was used for the patients in the control group. Data were collected using the “Vital Signs Follow-up Form” and “State Anxiety Inventory.” Results revealed that the mean State Anxiety Inventory score of the patients in the virtual reality group was statistically significantly lower than the control group (t = -11.854; P = .00; η2 = 0.508). While there was no significant difference between the groups in respiratory rate, systolic and diastolic blood pressure, oxygen saturation means at 0, 15, 30, 45, and 60 minutes and pulse rate means at 0 and 15 minutes (P > .05), pulse rate means at 30, 45, and 60 minutes were lower in the virtual reality group compared to the control group (P < .05). Virtual reality application during total knee replacement surgery did not affect all vital signs of patients, but only reduced the pulse rate and significantly reduced anxiety levels.

PMID:41824967 | DOI:10.1097/CIN.0000000000001515

JMIR Med Educ. 2026 Mar 13;12:e66999. doi: 10.2196/66999.

ABSTRACT

BACKGROUND: Effective interprofessional collaboration (IPC) is essential for patient safety; yet, poor teamwork and communication remain key challenges in high-pressure settings like the emergency department (ED), contributing to medication errors. Although Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)-based interprofessional education addresses these issues, adaptation in clinical settings remains difficult. To bridge this gap, we developed Emergency Room Virtual Simulation-Based Interprofessional Education (ER-VIPE), a multimodal, TeamSTEPPS-integrated intervention designed to enhance IPC and reduce medication errors.

OBJECTIVE: The aim of the study is to evaluate the effectiveness of ER-VIPE in enhancing IPC performance among emergency physicians, nurses, and pharmacists and in reducing medication errors. The primary objective is to assess changes in IPC performance in both real-world ED settings and in computer-based simulations. The secondary objective is to examine the intervention’s impact on medication error rates in the ED.

METHODS: This quasi-experimental study involved 15 interprofessional teams (each comprising 1 physician, 1 pharmacist, and 2 nurses), undergoing the ER-VIPE training. This multimodal intervention included 2 medical films, a massive open online course on TeamSTEPPS and IPC, and a computer-based simulation session on acute chest pain and cardiac arrest scenarios via the simulation-based interprofessional education (SIMBIE) platform. Co-debriefings were provided as a complement to the SIMBIE session, guiding participants through positive feedback and areas of improvement. TeamSTEPPS performance was measured using the Modified TeamSTEPPS and Team Performance Observation Tool (mTPOT) in both simulation and real-world ED settings. Generalized estimating equations with a Gaussian family, identity link, and exchangeable correlation structure were used to evaluate IPC score changes. Chi-square and Fisher exact tests were applied to compare near-miss and actual medication errors before and after the intervention. A 2-tailed P value <.05 was considered statistically significant.

RESULTS: The study was conducted from November 2023 to January 2024 at a university hospital with 60 participants. Following the co-debriefing session in the simulation, overall mTPOT scores increased by 2.00 points (P<.001), with the greatest improvement among physicians (+2.70), followed by nurses (+1.75) and pharmacists (+1.56). In the ED, most mTPOT domains improved significantly across all professions 2 months after the intervention (P<.001). Although no significant reduction in harmful medication errors was observed, reporting of near-miss prescription errors increased significantly (P=.01).

CONCLUSIONS: ER-VIPE enhanced IPC among ED physicians, nurses, and pharmacists, with sustained effects observed up to 2 months in real-world settings. The combination of medical films and massive open online courses provided accessible foundational knowledge, while computer-based virtual SIMBIE with co-debriefing reinforced practical communication and teamwork. Increased near-miss reporting suggests improved situational awareness and a more transparent safety culture. This multimodal training model shows promise for advancing collaboration and patient safety in emergency care.

PMID:41824952 | DOI:10.2196/66999

JMIR Mhealth Uhealth. 2026 Mar 13;14:e74206. doi: 10.2196/74206.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) incidence and mortality rates continue to be elevated even though effective screening methods are widely available. To increase CRC screening in primary care practices, our team developed a tablet-based digital health program (mPATH) designed to identify patients needing CRC screening, provide education, and empower patients to request a screening test via the program.

OBJECTIVE: This study aimed to qualitatively assess facilitators of and barriers to implementing and maintaining mPATH in primary care clinics.

METHODS: In a pragmatic implementation trial, clinics were randomized to receive only in-person training and technological support via phone or email (low touch) or added levels of support, such as at-elbow support during launch, regular check-ins, memos, and reports (high touch). After implementation and data collection were concluded, we conducted telephone interviews with health care providers, clinic managers, and front desk and nursing staff recruited from 8 primary care clinics of varying sizes and with varying degrees of implementation of mPATH. The interviews were designed to collect perceived facilitators of and barriers to using mPATH. All interviews were administered via telephone by a single project staff member with no prior contact with participants. Interviews were audio-recorded, and 2 study team members independently coded each interview transcript and developed a codebook to identify meaningful categories in the dataset. The coders met periodically to resolve discrepancies. Data within each category were abstracted and synthesized into themes. Themes were determined inductively by prevalence and salience in the data per the principles of thematic analysis.

RESULTS: A total of 33 interviews were completed between September 2021 and April 2023 with health care providers (n=8, 24.2%), clinic managers (n=9, 27.3%), nursing staff (n=8, 24.2%), and front desk staff (n=8, 24.2%). Interviews averaged 26.7 (SD 4.9) minutes. Barriers and facilitators identified varied among clinic sites and by clinic role. Overall, the primary factors supporting the implementation of mPATH were health care provider and staff buy-in, perceived potential time savings, and workflow improvement. The primary barriers identified were perceived lack of need for the program and technical issues. There was no significant indication that clinic size or randomization to low- or high-touch training and support played a role in the decision to continue or stop using the program.

CONCLUSIONS: Implementation of a tablet-based CRC screening tool in primary care practices is feasible with health care provider and staff buy-in and validation of potential time savings and workflow improvements but may be limited by perceived lack of need for the program and technical issues.

PMID:41824951 | DOI:10.2196/74206

JMIR Form Res. 2026 Mar 13;10:e91540. doi: 10.2196/91540.

ABSTRACT

BACKGROUND: The transition from acute to chronic pain often reflects a persistent dissociation between physical tissue damage and subjective reports. In alignment with the 2020 International Association for the Study of Pain definition, pain is a personal experience filtered through a latent “susceptibility architecture.” While clinical assessment currently relies on static, text-based questionnaires, these are often confounded by linguistic interpretation bias and cognitive literacy. We hypothesized that an individual’s internal psychological substrate-traditionally captured via text-can be characterized through real-time behavioral signatures during physical challenge.

OBJECTIVE: This study aimed to demonstrate that the “pain-prone” phenotype can be identified through high-frequency digital assessment of pain ratings. By correlating established psychometric traits with dynamic behavioral signatures, we sought to establish a foundation for “digital phenotyping” that moves beyond the limitations of linguistic self-reports.

METHODS: A cohort of 534 healthy volunteers (mean age 38.62, SD 22.35 years; n=336, 62.9% male and n=198, 37.1% female) underwent a controlled thermal stimulation protocol (36 °C, 44 °C, 46 °C, and 48 °C). Continuous pain intensity was recorded via a high-frequency (1000 Hz) digital visual analog scale (VAS). To establish a psychological baseline, participants were profiled using the Revised NEO Personality Inventory (NEO PI-R) and the Relationship Questionnaire. Two behavioral indexes were then derived from the digital VAS: the temporal augmentation index (TAI), reflecting within-stimulus physiological sensitization, and the cognitive contrast effect (evaluative instability). Statistical significance was adjusted using the false discovery rate.

RESULTS: Repeated-measure multivariate ANOVA confirmed a highly significant main effect of time for all noxious conditions (P<.001; 46 °C: t₅₃₃=27.69). Perceived intensity at 46 °C was significantly lower following 48 °C (mean VAS 12.31; SD 15.55) than following 36 °C (mean VAS 30.45; SD 22.38; t₅₃₃=-25.76; P<.001). Crucially, vulnerability (facet N6 of the NEO PI-R) was significantly associated with contrast magnitude (q=.03) and showed a trend for the TAI (q=.09), whereas self-discipline (facet C5) showed a significant negative association with the TAI (q=.048) and a trend for contrast magnitude (q=.09). Mediation analysis identified 2 distinct pathways: (1) a “stabilization path” where secure attachment fully mediated the inhibitory effect of facet C5 on evaluative instability (direct effect c’=-0.25; P=.11) and (2) an “instability path” where facet N6 exerted a direct amplifying effect on instability (c’=0.34; P=.03).

CONCLUSIONS: Subjective pain evaluation is governed by a stable internal psychological substrate. By shifting the assessment modality from linguistic self-reports to dynamic behavioral signatures, we provide a framework for “digital phenotyping.” These evaluation patterns serve as an objective behavioral marker, enabling the identification of latent susceptibility before chronification and offering a novel foundation for personalized precision pain management.

PMID:41824943 | DOI:10.2196/91540

Crit Rev Eukaryot Gene Expr. 2026;36(1):1-17. doi: 10.1615/CritRevEukaryotGeneExpr.2025062255.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) remains a major global health burden, and genetic factors such as vitamin D receptor (VDR) polymorphisms have been implicated in its pathogenesis. However, the translational relevance of these variants in clinical risk stratification remains unclear.

METHODS: We conducted a comprehensive meta-analysis of case-control studies assessing the association between four common VDR single-nucleotide polymorphisms (Fok1, Apa1, Bsm1, and Taq1) and CRC risk, integrating data from PubMed, Embase, Google Scholar, and other sources through 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under multiple genetic models. Heterogeneity, publication bias, and sensitivity analyses were performed. Statistical power was evaluated using G*Power 3.1.

RESULTS: Across 24 datasets from diverse ethnic populations, no significant associations were observed for any of the four VDR variants in allelic, dominant, recessive, or overdominant models. Statistical power exceeded 0.99 for all variants, indicating that the null results were unlikely due to sample size limitations.

CONCLUSION: This study provides robust evidence that these common VDR polymorphisms are not clinically functional as biomarkers for CRC susceptibility. Eliminating these variants from biomarker panels can help redirect resources toward more promising genetic or molecular predictors. These findings also reinforce the need for integrative studies exploring gene-environment interactions, particularly vitamin D status, diet, and lifestyle, to clarify the role of vitamin D pathways in CRC prevention and treatment.

PMID:41824933 | DOI:10.1615/CritRevEukaryotGeneExpr.2025062255

Medicine (Baltimore). 2026 Mar 13;105(11):e47975. doi: 10.1097/MD.0000000000047975.

ABSTRACT

Prostate cancer is one of the most common and serious cancers among Iranian men. Given the high prevalence of opium use in Iran and its classification as a group 1 carcinogen, understanding its potential association with prostate cancer is of clinical and public health importance. This study aimed to evaluate the relationship between opium consumption and pathological findings of prostate biopsy among men referred to Shahid Bahonar Hospital in Kerman. This retrospective cross-sectional study included 441 men who underwent prostate biopsy between 2014 and 2019 due to elevated prostate-specific antigen (PSA > 4 ng/mL) or abnormal digital rectal examination. Patients with a previous diagnosis of prostate cancer, history of pelvic radiotherapy, or a family history of prostate cancer were excluded. Participants were categorized into opium users (n = 143) and non-users (n = 298) based on self-reported opium consumption. Demographic characteristics, PSA levels, prostate volume, Gleason score, clinical and pathological stage, and risk group were extracted from medical records. Statistical analyses were performed using independent t-test and chi-square test with a significance level of .05. There were no significant differences in age or body mass index between the 2 groups (P > .05). The proportion of biopsy-confirmed prostate cancer was significantly higher in non-users (63.8%) compared with opium users (53.1%; P = .033). Mean PSA level was also significantly higher in non-users (54.22 ± 1.64) than in opium users (52.28 ± 2.64; P = .046). No significant differences were observed between the groups regarding prostate volume, Gleason score, clinical stage, pathological stage, or risk group classification (P > .05). Opium consumption was not associated with more advanced clinical or pathological features of prostate cancer. However, opium users showed lower PSA levels and a lower rate of cancer detection compared with non-users, suggesting that opium may influence PSA levels and potentially affect prostate cancer detection. Further studies are recommended to clarify the biological effects of opium on PSA and diagnostic accuracy.

PMID:41824892 | DOI:10.1097/MD.0000000000047975

Medicine (Baltimore). 2026 Mar 13;105(11):e47986. doi: 10.1097/MD.0000000000047986.

ABSTRACT

Examining pediatric hospitalization profile is important for healthcare planning and provision. The aim of this study was to identify the most common causes of hospitalization for the pediatric population in Australia between 1998 and 2019. This was an ecological study that examined the hospitalization profile for pediatric population in Australia using the National Hospital Morbidity Database. Between 1998 and 2019, there were 16,966,610 reported hospital admission episodes among the pediatric population in Australia. The number of annual admissions increased by 23.0%. Children who were admitted to the hospital for overnight-stay admissions comprised 55.9% of all admissions. Rates of same-day hospital admission among pediatrics increased by 22.1% [from 5596.7 (95% confidence interval [CI]: 5577.0-5616.4) in 1998 to 6832.1 (95% CI: 6812.3-6851.9) in 2019 per 100,000 persons, P ≤ .05]. Rates of overnight-stay hospital admission among pediatrics declined by 9.7%. Diseases of the respiratory system accounted for 15.1% of all hospital admissions. Hospital admission rates among females rose by 6.1% [from 13294.5 (95% CI: 13,252.8-13,336.2) in 1998 to 14,105.5 (95% CI: 14,066.2-14,144.7) in 2019 per 100,000 persons], compared to a 0.1% increase among males. While pediatric hospital admission counts increased substantially, the overall hospitalization rate remained largely stable. Important shifts were observed, including a rise in same-day admissions and higher admission rates among females. The predominance of respiratory conditions in young children and increasing hospitalizations in adolescents, particularly females, highlights the need for targeted strategies such as improved respiratory infection prevention, early parental guidance for acute illness, injury prevention programs, and expanded youth mental health services.

PMID:41824890 | DOI:10.1097/MD.0000000000047986

Medicine (Baltimore). 2026 Mar 13;105(11):e47990. doi: 10.1097/MD.0000000000047990.

ABSTRACT

BACKGROUND: The adaptogenic effects of Ashwagandha root extract are evident. An earlier study showed the therapeutic effects of a once-daily sustained-release (SR) formulation (300 mg) of Ashwagandha root extract over an extended period. This study aimed to evaluate the efficacy and safety of Ashwagandha root extract sustained-release (AshwaSR) 150 and 300 mg capsules in reducing stress in healthy adult, stressed subjects.

METHODS: In this double-blind, randomized, placebo-controlled trial, healthy subjects with Perceived Stress Scale score 14 to 26 were randomized (1:1:1) to AshwaSR 150 mg (group A) or 300 mg (group B) or placebo (group C). Change from baseline to day 60 was evaluated for stress levels, sleep quality, psychological well-being, eating behavior, and serum cortisol levels in all groups.

RESULTS: Of 135 subjects randomized, 126 completed the trial (mean age, 34.79 ± 8.16 years). Mean Perceived Stress Scale scores significantly reduced from baseline to day 60 in group A and B (mean change, 38.6% and 41.6% respectively; P < .001). Sleep quality, psychological well-being, and eating behavior significantly improved from baseline to day 60 in groups A and B (P < .001). Serum cortisol levels in group B were significantly reduced on day 60 (P < .05). Both group A and B showed significant improvements in stress levels, sleep quality, psychological well-being, and eating behavior at day 60 (P < .05) compared to group C. No safety concerns were reported.

CONCLUSION: AshwaSR 150 and 300 mg capsules reduced perceived stress and improved sleep quality, eating behavior, and psychological well-being and were safe in healthy adult, stressed subjects over 60 days of administration.

PMID:41824889 | DOI:10.1097/MD.0000000000047990

Medicine (Baltimore). 2026 Mar 13;105(11):e48006. doi: 10.1097/MD.0000000000048006.

ABSTRACT

Caregivers of individuals with rare genetic diseases experience substantial and persistent challenges that negatively affect their quality of life (QoL) and increase their burden. This study explored factors associated with caregiver QoL and burden in South Korea, focusing on patient characteristics, treatment availability, and genetic counseling experience. A cross-sectional survey was conducted with 159 caregivers of patients with rare genetic diseases at a tertiary general hospital. Caregiver QoL and burden were measured using the Caregiver QoL Scale and the Korean version of the Burden Assessment Scale. Demographic and clinical characteristics were also collected. Statistical analyses were performed using R software. Group differences were evaluated using Welch t tests, Wilcoxon rank-sum tests, and one-way analysis of variance with post hoc tests. Correlation analyses examined associations between QoL and caregiver burden. Caregiver QoL was significantly higher among those caring for minors, whereas caregiver burden was significantly higher among those caring for patients with registered disabilities. Treatment availability was associated with higher caregiver QoL and lower burden. Disease category also influenced outcomes: caregivers of patients with progressive conditions and localized impairments reported significantly lower QoL than those caring for patients with chronic conditions with effective treatment or symptomatic care or stable conditions with disabilities. Conversely, caregivers of patients with fatal diseases lacking effective treatment reported significantly higher burden than those caring for patients with chronic conditions with effective treatment. Caregiver QoL and burden were strongly and negatively correlated. Most caregivers (68.6%) had no prior genetic counseling experience, although those with counseling experience reported higher family openness scores, a QoL subdomain. Caregiver QoL and burden are closely linked to patient characteristics, treatment availability, and contextual caregiving demands. Expanding access to effective treatments, improving service accessibility, and integrating genetic counseling into caregiver support systems may improve the well-being of families affected by rare genetic diseases.

PMID:41824885 | DOI:10.1097/MD.0000000000048006