Category: Nevin Manimala

J Environ Manage. 2026 Mar 31;404:129407. doi: 10.1016/j.jenvman.2026.129407. Online ahead of print.

ABSTRACT

Recent drinking water regulations have imposed remediation for per- and polyfluoroalkyl substances (PFAS). In response, treatment facilities may be required to retrofit existing treatment schemes to treat PFAS below maximum contaminant levels (MCLs). Adsorption technologies such as granular activated carbon (GAC) and ion exchange (IX) have been demonstrated to be effective; however, there are limited techno-economic metrics available that provide guidance on technology selection and design for diverse PFAS-containing source water conditions. Process systems engineering (PSE) tools that traditionally perform these analyses are hindered by the data availability, model validity, and understanding of treatment phenomena for emerging contaminants. This work employs published data regressions, statistical models, process models, techno-economic analyses, and other process systems tools in a model-based uncertainty framework to consider the limitations of emerging contaminant research. Through this analysis framework, economic results are provided as probabilistic distributions based on the uncertainty of the models and diverse conditions that treatment facilities experience. Regressed parameter distributions and model predictive performance trends for each technology are identified based on PFAS structure and chain length. GAC systems are evaluated at consistently lower levelized costs of water (LCOWs) with less economic risk over IX systems considering uncertainty across most design conditions and PFAS species. Both technologies are evaluated to have comparable adsorbent usage intensity on a volume basis, indicative of similar sustainability.

PMID:41921266 | DOI:10.1016/j.jenvman.2026.129407

Transl Oncol. 2026 Mar 31;67:102744. doi: 10.1016/j.tranon.2026.102744. Online ahead of print.

ABSTRACT

BACKGROUND: Post-treatment disease monitoring of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) is challenging. Liquid biopsies could improve disease monitoring, but the variety in methods hampers clinical implementation. In this study, target-enrichment sequencing to detect circulating tumor HPV DNA (ctHPV-DNA) was applied in liquid biopsies of HPV-positive OPSCC patients, and robust statistical readouts determined. Next, it was investigated whether longitudinal plasma monitoring could accurately diagnose residual and recurrent disease.

METHODS: The target-enrichment panel included 29 cancer genes and high-risk HPV genomes. The assay was tested on plasma from 30 non-cancer controls and 33 patients with HPV-positive tumors, 15 of whom had residual or recurrent disease, and 18 who remained disease-free. Samples were analyzed from baseline to 24 months after treatment.

RESULTS: By determining and applying robust statistical cut-off values, ctHPV-DNA could be detected in plasma of all patients with HPV-positive OPSCC at baseline, and was absent in plasma of all non-cancer controls. In OPSCC patients who remained disease-free, post-treatment plasma samples were negative for ctHPV-DNA. In contrast, ctHPV-DNA was detected in plasma of all OPSCC patients with recurrent disease to a year before clinical diagnosis. Cases suspect for residual disease in the neck, but with a necrotic metastasis without vital tumor after resection, tested correctly negative for ctHPV-DNA in plasma.

CONCLUSIONS: Target-enrichment sequencing of plasma shows 100% accurate detection of ctHPV-DNA at baseline. Longitudinal monitoring enables early recurrence detection and correct diagnosis of non-vital residual disease. The data indicate that liquid biopsy could improve post-treatment follow-up in HPV-positive OPSCC patients.

PMID:41921264 | DOI:10.1016/j.tranon.2026.102744

J Psychiatr Res. 2026 Mar 26;198:203-209. doi: 10.1016/j.jpsychires.2026.03.043. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying baseline clinical characteristics associated with treatment response is crucial for optimising intervention strategies in people with autism spectrum disorder (ASD). This study aimed to distinguish responders from non-responders to a multisession prefrontal transcranial direct current stimulation (tDCS) protocol and to explore how baseline individual characteristics relate to treatment outcomes.

METHODS: Using complementary inferential statistics and predictive modelling approaches, we analysed baseline clinical characteristics of adolescents and young adults with ASD who underwent cathodal tDCS (1.5 mA) over the left dorsolateral prefrontal cortex, coupled with cognitive remediation training. Baseline symptom severity was assessed using the Autism Diagnostic Interview-Revised (ADI-R). Normalised feature importance and Shapley additive explanations (SHAP) were used to identify features associated with restricted and repetitive behaviour (RRB) reduction, and a model-derived classification threshold was estimated to stratify potential responders and non-responders within this protocol.

RESULTS: Inferential statistics revealed that responders had significantly lower social interaction symptom severity than non-responders (p < .001; Cohen’s d = 0.41). Predictive modelling further indicated that lower baseline verbal communication severity was associated with greater RRB reduction (averaged SHAP value across models = -0.017). A model-derived classification threshold of 19.6 on the ADI-R verbal communication sub-score was identified to differentiate responders and non-responders within this protocol.

CONCLUSION: Lower baseline verbal communication severity is associated with greater behavioural improvement following this multisession prefrontal tDCS protocol. These findings should be interpreted as exploratory and hypothesis-generating. Replication in larger, independent cohorts is required to assess the robustness and generalisability of these findings.

TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT05035511).

PMID:41921246 | DOI:10.1016/j.jpsychires.2026.03.043

J Psychiatr Res. 2026 Mar 17;198:194-202. doi: 10.1016/j.jpsychires.2026.03.019. Online ahead of print.

ABSTRACT

PURPOSE: US service members and veterans (SMVs) are at an increased risk for both concussion and mental health disorders such as depression and post-traumatic stress disorders (PTSD). Although depression history has been shown associated with elevated post-concussive depressive symptoms, it is unclear whether this relationship changes in the presence of other mental health conditions such as PTSD. This study evaluated whether the relationship between depression history and the level of post-concussive depressive symptoms varied by pre-injury PTSD.

METHODS: Data from 427 SMVs with concussion history from a US military medical center was used for this cross-sectional study. Concussion, pre-injury depression, and PTSD were assessed through medical record review and self-report, and the level of post-injury depressive symptoms was measured using the Center for Epidemiologic Studies- Depression Scale. Poisson regression with robust error variance was utilized to evaluate the association of pre-injury depression with clinically-elevated depressive symptoms post-injury, and interaction by pre-injury PTSD.

RESULTS: Participants with (vs. without) pre-injury depression were significantly more likely to have clinically-elevated depressive symptoms post-injury, but only in the presence of pre-injury PTSD (PR = 2.02, CI = 1.45, 2.81) and not without (PR = 1.12, CI = 0.84, 1.50). Interaction by pre-injury PTSD was statistically significant (p < 0.001).

CONCLUSIONS: Depression history has been shown to elevate post-concussive depressive symptoms; however, the findings of this study suggest that this association may exist only in the presence of pre-injury PTSD. Identification of SMVs with concomitant depression and PTSD history may further inform the concussion treatment of those who may likely have clinically-elevated post-concussive depressive symptoms.

PMID:41921245 | DOI:10.1016/j.jpsychires.2026.03.019

Accid Anal Prev. 2026 Mar 31;232:108536. doi: 10.1016/j.aap.2026.108536. Online ahead of print.

ABSTRACT

This cohort study investigates the long-term effects of simulator-based hazard awareness training (HAT) on learner and novice drivers in the Netherlands, using a dataset of 2,372 participants over a 15-year period. Most prior studies on HAT have measured only immediate post-training outcomes; no longitudinal cohort study with a control group has previously examined both supervised and unsupervised driving outcomes over a multi-year horizon. Although the HAT and control groups showed small but statistically significant differences in gender composition, education level, and fear of driving at the start of training, the effect sizes were negligible (d ≤ 0.09), and these characteristics are addressed as covariates in the analyses. HAT improved performance during simulator training and supervised driving: HAT students’ viewing skills were better during the intersection test, required fewer on-road training hours, passed the driving exam in fewer attempts, and achieved a higher first-attempt pass rate than the control group. These benefits did not persist into unsupervised post-licensing driving. Violations, errors, and accident involvement were comparable between HAT and control group drivers in the first and last year after licensing. Personal characteristics – including gender, licensing age, self-assessed driving competence, and subjective driving difficulty – were stronger and more lasting predictors of post-licensing behaviour than training type. These findings suggest that hazard awareness is a trainable skill, but that training effects on risk-taking behaviour are moderated by individual characteristics that emerge most clearly once drivers operate independently, aligning with findings of a previous study on the same dataset. Teaching higher safety margins during supervised driving may offer a more durable route to reducing accident risk for novice drivers than higher-order skill training alone.

PMID:41921244 | DOI:10.1016/j.aap.2026.108536

Accid Anal Prev. 2026 Mar 31;232:108456. doi: 10.1016/j.aap.2026.108456. Online ahead of print.

ABSTRACT

Real-time corridor-wide crash-occurrence risk (COR) prediction is challenging, since existing near-miss EVT models oversimplify collision geometry, neglect vehicle-infrastructure (V-I) interactions, and fail to adequately account for spatial heterogeneity in traffic and roadway conditions. To do so, this study develops a geometry-aware 2D-TTC near-miss extraction and integrates it with a hierarchical Bayesian structure grouped random parameters (HBSGRP-UGEV) to estimate short-term COR in urban corridors. Building on prior grouped EVT formulations while explicitly accommodating both V-V and V-I near-miss processes within a unified corridor-wide modeling framework. High-resolution trajectories from the Argoverse-2 dataset were analyzed across 28 sites on Miami’s Biscayne Boulevard to extract extreme near-miss events. The model incorporates vehicle dynamics and roadway features as covariates, with partial pooling across segments and intersections to capture corridor-wide heterogeneity. Results show that the HBSGRP-UGEV framework outperforms fixed-parameter HBSFP-UGEV models, reducing DIC by up to 7.5% (V-V) and 3.1% (V-I). Predictive validation using ROC-AUC confirms strong accuracy (0.89 for V-V segments, 0.82 for intersections, 0.79 for V-I segments, and 0.75 for intersections). Grouped random-parameters (HBSGRP) framework indicate that relative (speed, distance, and deceleration) dominate V-V near-miss risk on segments, whereas V-I segment risk is primarily associated with relative distance; at intersections, V-V risk is driven by relative (speed and distance), while V-I dynamics exhibit no statistically significant effects. These findings demonstrate the value of a geometry-aware, spatially adaptive framework for proactive corridor safety management, supporting both real-time interventions and long-term Vision Zero goals.

PMID:41921243 | DOI:10.1016/j.aap.2026.108456

Eur J Radiol. 2026 Mar 19;199:112792. doi: 10.1016/j.ejrad.2026.112792. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluated whether extending the conventional Stewart ultrasound protocol to include the ankle (ankle-inclusive protocol) improves monosodium urate (MSU) crystal detection in asymptomatic hyperuricemia (AH), compared to further extension with the second metatarsophalangeal joint (MTP2-extended protocol), and whether quantitative crystal burden correlates with subclinical inflammation.

METHODS: In this retrospective single-center study, 94 adults with AH and with no history of clinical gout underwent three ultrasound protocols: Stewart (knees, MTP1), ankle-inclusive (knees, MTP1, ankles), and MTP2-extended (knees, MTP1, ankles, MTP2). MSU crystals and Power Doppler (PD) signals were defined per OMERACT 2021. A novel ankle crystal load score (crystal_score) was developed. Statistical analyses included McNemar’s test, ROC analysis, and multivariable logistic regression.

RESULTS: Adding ankle assessment to the Stewart protocol significantly increased MSU crystal detection by 14.9% (85.1% vs. 70.2%, p < 0.001), whereas subsequent MTP2 addition provided no significant gain (4.3%, p = 0.125). Of the 14 cases detected solely by ankle assessment, the majority (85.7%, 12/14) belonged to the high-risk subgroup (serum uric acid [SUA] ≥ 480 μmol/L), and 28.6% (4/14) exhibited PD signals at the ankle. The crystal_score demonstrated significant discriminative ability for subclinical inflammation (AUC = 0.677, p = 0.003) and was an independent predictor after adjustment (adjusted OR = 1.16 per unit, p = 0.001), particularly in patients with SUA < 480 μmol/L (AUC = 0.709, p = 0.013).

CONCLUSION: Ankle ultrasonography significantly improves MSU crystal detection in AH and should be integrated into screening protocols. The crystal_score has significant discriminative ability as a quantifiable biomarker for subclinical inflammation, especially in patients with SUA < 480 μmol/L, with its moderate correlation (Spearman’s ρ = 0.333) reflecting the “silent deposition” phase of AH. MTP2 assessment can be omitted.These findings support standardized, risk-stratified ultrasound workflows for AH management.

PMID:41921238 | DOI:10.1016/j.ejrad.2026.112792

J Pediatr Hematol Oncol. 2026 Mar 30. doi: 10.1097/MPH.0000000000003195. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare postoperative visual outcomes in pediatric patients undergoing resection of craniopharyngioma via endoscopic endonasal versus transcranial craniotomy approaches.

METHODS: We retrospectively reviewed 37 pediatric patients (74 eyes) who underwent resection of histologically confirmed craniopharyngioma at a tertiary center between 1995 and 2023. Ophthalmologic evaluations included best-corrected visual acuity (VA), optic nerve findings, and visual fields. Outcomes were assessed at early, intermediate, and long-term follow-up and compared by surgical approach.

RESULTS: Twenty-five patients (68%) underwent craniotomy and 12 (32%) endoscopic resection. Preoperatively, 51% had normal vision in both eyes, while 6 were legally blind. Postoperatively, no significant differences in VA or visual fields were observed between approaches at any interval. Optic nerve pallor was somewhat more frequent in the endoscopic group, though not statistically significant. Gross total resection was achieved in 66% of endoscopic versus 34% of craniotomy cases. Most craniotomies (88%) occurred before 2015, compared with 16% of endoscopic cases.

CONCLUSIONS: Both endoscopic and transcranial approaches yielded comparable visual outcomes in pediatric craniopharyngioma surgery. Rates of gross total resection were higher in the endoscopic cohort, suggesting that surgical approach should remain anatomy-driven, with either technique capable of preserving visual function in appropriately selected patients.

PMID:41921232 | DOI:10.1097/MPH.0000000000003195

J Med Internet Res. 2026 Apr 1;28:e75458. doi: 10.2196/75458.

ABSTRACT

BACKGROUND: Research on the effectiveness of digital health campaign strategies is lacking. Understanding performance outcomes is essential for the successful implementation of campaigns. Two studies examined platforms, tactics, and content of digital health campaigns using paid media performance data.

OBJECTIVE: This analysis compared 2 digital advertising methods (social media and banner or display) using click-through rate (CTR) and cost-per-click (CPC) as performance measures. Performance differences by state, community type, message approach, format, and image type were assessed. CTR and CPC served as measures in determining performance differences between social media and banner or display.

METHODS: This cross-sectional secondary analysis examined campaign performance for the HEALing (Helping to End Addiction Long-Term) Communities Study, which served 85,875,105 impressions. Data were collected from media buy reports, entered into templates that included method (display or banner and social media) and key performance indicators (impressions, clicks, and media spend), and CTR and CPC were calculated. Study 1 assessed differences in CTR and CPC for social media and banner or display by state (KY, NY, MA, and OH) and community type (urban and rural). Study 2 assessed differences in CTR for social media and banner or display by state (KY, NY, MA, and OH), community type (urban and rural), message approach (testimonial and information-based), format (motion graphic or graphics interchange format, video, and static image), and image type (local and stock). Separate analyses were conducted for each advertising method.

RESULTS: Study 1 found significant differences between advertising methods, where social media had higher CTR compared to banner or display. Social media had a significant main effect for state, where OH had the highest CTR. There was a statistically significant difference in CPC based on advertising method, where social media had a lower CPC compared to banner or display. Social media had a significant main effect for state, where OH had the lowest CPC. Banner or display had a significant main effect for state and community type, where OH and urban communities had the highest CPC. Study 2 found significant differences between advertising methods, where social media had higher CTR than banner or display. For social media, urban communities, static format, and local spokespersons had the highest CTR. There were significant differences between all pairs of states, where OH had the highest CTR. For display or banner, static format and local spokespersons had the highest CTR.

CONCLUSIONS: This analysis provides guidance for digital health campaigns. It examined the performance of opioid use disorder campaigns using CTR and CPC measures, demonstrating utility in future campaign evaluations. Social media was more related to stimulating responses to campaign messages compared to banner or display. State-to-state variations emphasized the importance of message pilot testing. Using local spokespersons versus stock spokespersons is recommended.

PMID:41921212 | DOI:10.2196/75458

JMIR Hum Factors. 2026 Apr 1;13:e83857. doi: 10.2196/83857.

ABSTRACT

BACKGROUND: Over-the-counter (OTC) hearing aids were introduced to improve the affordability and accessibility of hearing health care for adults with perceived mild-to-moderate hearing loss. While these devices have demonstrated effectiveness in cognitively healthy older adults-particularly in the domains of audibility, self-reported hearing ability, and speech recognition in quiet-their use and outcomes in people with dementia remain underexplored. This issue warrants further attention, as people with dementia often experience co-occurring hearing loss and may rely on OTC hearing aids to overcome cost and access barriers to prescription amplification. However, given the cognitive and functional challenges of dementia, it is unclear whether and how OTC hearing aids can support the hearing care needs of these individuals.

OBJECTIVE: To explore interest-holder perspectives on the feasibility and acceptability of OTC hearing aids for community-dwelling older adults with dementia, identifying key facilitators and barriers that influence their use in this population.

METHODS: Semistructured interviews were conducted with 45 participants across three interest-holder groups (15 per group): (1) community-dwelling older adults with dementia and hearing loss, (2) family caregivers of community-dwelling older adults with dementia and hearing loss, and (3) geriatric direct care professionals. Interviews were conducted and recorded via secure Zoom (Zoom Communications) videoconferencing, then transcribed and analyzed using thematic analysis.

RESULTS: Participants endorsed several facilitators and barriers to OTC hearing aid use in people with dementia. Facilitators included increased accessibility, perceived affordability and value, and enhanced autonomy and control. Barriers included mistrust of OTC hearing aids, difficulty assessing candidacy due to unreliable self- and proxy reports of hearing status, caregiver uncertainty regarding device programming and adjustment, challenges evaluating device effectiveness, and concerns about caregiver burden and burnout from long-term device management.

CONCLUSIONS: OTC hearing aids offer meaningful advantages for people with dementia and their family caregivers. However, significant barriers must be addressed to ensure their feasibility and acceptability for this population. Future research should further examine and quantify these barriers to inform the development of tailored devices, services, and delivery models that promote successful OTC hearing aid use in people with dementia and their family caregivers.

PMID:41921210 | DOI:10.2196/83857