Nevin Manimala

JMIR Mhealth Uhealth. 2026 Mar 6;14:e77935. doi: 10.2196/77935.

ABSTRACT

BACKGROUND: Accurate limb circumference measurement is essential for the diagnosis and management of lymphedema, facilitating the objective evaluation of treatment outcomes and early detection of disease progression. Although manual tape measurements are inexpensive and widely used, they are limited by interobserver variability and low reproducibility. Advanced modalities such as computed tomography and magnetic resonance imaging provide high precision but are costly and impractical for routine or home-based use. To overcome these limitations, we developed and validated a novel 3D measurement system that integrates a marker-based bodysuit (ZOZOSUIT2) with a smartphone app, enabling fast, accurate, and reproducible limb circumference assessment.

OBJECTIVE: This study aimed to evaluate the accuracy, repeatability, and time efficiency of the 3D measurement bodysuit and smartphone system compared with those of manual tape measurements in patients with upper and lower limb lymphedema.

METHODS: This prospective study included 26 patients (n=10 with upper limb lymphedema and n=16 with lower limb lymphedema). Using the ZOZOSUIT2, which contains approximately 20,000 dot markers, 12 full-body photographs were captured with a smartphone, and a 3D model was automatically generated. Circumference values were extracted at 10 standardized points on the upper limb (from the wrist to the top of the upper arm) and 9 on the lower limb (from the ankle to the base of the thigh). Each measurement was repeated 3 times to assess repeatability. Manual tape measurements were used as the reference standard. For each measurement point, the repeatability (intrameasurement variation) and the mean absolute error between the 2 methods were calculated. Measurement time was also recorded for both methods and compared statistically using the Wilcoxon signed-rank test.

RESULTS: Across all measurement points, the median repeatability of the bodysuit smartphone system ranged from 2.2 to 6.4 mm, indicating high reproducibility. When compared with manual measurements, the median of the mean absolute error for upper limb points ranged from 6.7 to 20.5 mm, and for lower limb points ranged from 5.5 to 15.9 mm. Relatively larger discrepancies were observed at the wrist (median 19.8, IQR 15.5-24.1 mm), 5 cm proximal to the wrist (median 20.5, IQR 8.5-28.1 mm), and the base of the thigh (median 15.9, IQR 10.2-25.9 mm). Mean measurement time was significantly shorter with the bodysuit smartphone system (88.2, SD 16.0 seconds) than with manual tape measurement (293.8, SD 58.5 seconds; P<.001).

CONCLUSIONS: The bodysuit smartphone system enables rapid, precise, and highly reproducible limb circumference assessment in patients with lymphedema. Despite minor differences at anatomical sites with complex contours, such as the wrist and the thigh base, the overall accuracy and time efficiency were clinically acceptable. This system may serve as a practical and scalable solution for both clinical and home-based lymphedema monitoring, contributing to the objective and standardized assessment of limb volume.

PMID:41791111 | DOI:10.2196/77935

J Med Internet Res. 2026 Mar 6;28:e85516. doi: 10.2196/85516.

ABSTRACT

BACKGROUND: Surveys show that many people are willing to use generative artificial intelligence (AI) for health questions. Prior research has largely focused on chatbot accuracy, with some studies finding that both physicians and consumers overwhelmingly prefer chatbot-generated text over physician responses.

OBJECTIVE: This study aimed to characterize and compare the emotional content of responses from physicians and 2 AI chatbots (OpenAI’s ChatGPT and Google’s Gemini) and to assess differences in reading level and use of medical disclaimers.

METHODS: A public, patient-deidentified telehealth website was used to compile 100 physician-answered questions. The same questions were posed to both chatbots between May 18 and 19, 2025. Two coders classified the emotional content of each sentence using a predefined codebook and reviewed for agreement. Emotions were ranked as primary, secondary, and tertiary by the proportion of sentences classified as each emotion per response. Multinomial logistic regression compared emotional rankings using physician responses as the reference. Word count, Flesch Reading Ease, and Flesch-Kincaid Grade Level were analyzed via ANOVA with the Tukey honestly significant difference test. Disclaimer use was compared between chatbots using a χ² test.

RESULTS: Primary emotions were overwhelmingly neutral, except for one response from each chatbot in which anger was primary. For secondary emotions, the odds ratio of hope was 80.28% (95% CI 37.71%-93.76%) lower for ChatGPT, while the odds ratio of fear was 3.29 (95% CI 1.44-7.49) times higher for Gemini. For tertiary emotions, the odds ratio of compassion was 1.94 (95% CI 1.06-3.54) times higher, and the odds ratio of having no tertiary emotion was 84.33% (95% CI 64.72%-93.04%) lower for Gemini. Gemini responses averaged 889.1 (SD 305.7) words, ChatGPT 476.5 (SD 109.5), and physicians 193.5 (SD 113.6). Gemini had the lowest average Flesch Reading Ease score at 39.9 (SD 8.8), followed by ChatGPT at 45.8 (SD 12.8), while physicians had the highest at 51.9 (SD 13.6). Gemini had the highest average Flesch-Kincaid Grade Level at 11.3 (SD 1.5), followed by ChatGPT at 9.9 (SD 1.9), and physicians at 9.2 (SD 2.4). Gemini was significantly more likely to include a disclaimer than ChatGPT (χ²₁=49.2; P<.001).

CONCLUSIONS: Chatbot responses were significantly (P<.001) longer and more difficult to read than physician responses and were more likely to contain a wider range of emotions. Qualitatively, chatbot responses were more varied in their presentation as well as in the breadth of the emotions themselves. The findings of this study could be used to inform more emotionally connected physician responses to patient message queries.

PMID:41791109 | DOI:10.2196/85516

JMIR Res Protoc. 2026 Mar 6;15:e84038. doi: 10.2196/84038.

ABSTRACT

BACKGROUND: Areca nut (AN) is a commonly consumed psychoactive substance, especially in South and Southeast Asia. Chronic chewing of AN has been linked to multiple health problems, including temporomandibular joint (TMJ) disorders. Excessive strain on TMJ during chronic AN chewing can lead to repetitive injury, resulting in microtrauma and macrotrauma to both the TMJ and the surrounding masticatory structures. Previous studies have reported the long-term impact of AN chewing on TMJ by using conventional 2D imaging.

OBJECTIVE: This study aims to evaluate and compare condylar morphology in chronic AN chewers and nonchewers by using 3D imaging.

METHODS: This study will include 90 patients who will be divided into 2 groups: chronic AN chewers (n=45, 50%) and nonchewers (n=45, 50%). The study will be undertaken after obtaining institutional ethics committee approval and written informed consent from each patient. A detailed habit history of all the participants will be recorded. Each patient will undergo a clinical examination and radiographic evaluation of condylar morphology. Condylar morphology will be evaluated using cone beam computed tomography scans in both sagittal and coronal planes. All the findings will be recorded and then examined for statistical significance.

RESULTS: On comparison of condylar morphology between chronic AN chewers and nonchewers by using cone beam computed tomography, statistical variations relevant to structural and pathological alterations such as osteophytes, surface flattening, and erosions are likely to occur.

CONCLUSIONS: This study aims to overcome the limitations of conventional 2D radiography and provide a more accurate assessment of condylar morphology. The findings should fill an existing gap in the literature by providing useful insights on the effects of chronic AN chewing on condylar structure by using 3D imaging. This research may help to improve the diagnosis, prevention, and management of TMJ disorders.

TRIAL REGISTRATION: Clinical Trials Registry-India CTRI/2025/06/088238; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTMzNzQz&Enc=&userName=.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/84038.

PMID:41791104 | DOI:10.2196/84038

Phys Rev Lett. 2026 Feb 20;136(7):077101. doi: 10.1103/xgkj-dxzh.

ABSTRACT

We propose a method for inferring entropy production (EP) in high-dimensional stochastic systems, including many-body systems and non-Markovian systems with long memory. Standard techniques for estimating EP become intractable in such systems due to computational and statistical limitations. We infer trajectory-level EP and lower bounds on average EP by exploiting a nonequilibrium analogue of the maximum entropy principle, along with convex duality. Our approach uses only samples of trajectory observables, such as spatiotemporal correlations. It does not require reconstruction of high-dimensional probability distributions or rate matrices, nor impose any special assumptions such as discrete states or multipartite dynamics. In addition, it may be used to compute a hierarchical decomposition of EP, reflecting contributions from different interaction orders, and it has an intuitive physical interpretation as a “thermodynamic uncertainty relation.” We demonstrate its numerical performance on a disordered nonequilibrium spin model with 1000 spins and a large neural spike-train dataset.

PMID:41791056 | DOI:10.1103/xgkj-dxzh

Phys Rev Lett. 2026 Feb 20;136(7):078301. doi: 10.1103/6cdq-1nvv.

ABSTRACT

Many swimming microorganisms navigate their environment by modulating the curvature of their swimming trajectories in response to external cues. Here, we show that the biflagellate alga Chlamydomonas reinhardtii swims in circles and actively switches its trajectory handedness in response to orthogonal illumination: the cell swims counterclockwise at low light intensities yet clockwise at high light intensities. This handedness switching arises from light-dependent modulation of flagellar beating, including rapid and reversible changes in beat extension, phase, and-crucially-beat plane orientation. Using high-speed imaging and hydrodynamic modeling, we reveal that this beat plane reorientation is critical for Chlamydomonas to swim orthogonally to light as well as to dynamically modulate its trajectory curvature, enabling transitions between global exploration and localized searching in spatially structured light fields. Our results establish beat plane reorientation as a novel mechanism for curvature control in microswimmer navigation.

PMID:41791052 | DOI:10.1103/6cdq-1nvv

Phys Rev Lett. 2026 Feb 20;136(7):076301. doi: 10.1103/td98-5ltj.

ABSTRACT

Collision of quantum particles remains an effective way of probing their mutual statistics. Colliders based on quantum point contacts in quantum Hall edge states have been successfully used to probe the statistics of the underlying quantum particles. Notwithstanding the extensive theoretical work focusing on pointlike colliders, when it comes to experiment, the colliders are rarely pointlike objects and can support a resonant level or multiple tunneling points. We present a study of a paradigmatic extended (non-point-like) fermionic collider (and an extension to bosonic colliders). As with particle interferometers, in an extended collider there is an infinite number of trajectories for any single- or multiparticle event. Self-interference of the former can lead to an apparent bunching of fermions when we compare the cross-current correlator with a classical benchmark representing two colliding beams. In view of this apparent bunching behavior of fermions, we identify an experimentally accessible current correlator, which reveals the true mutual statistics of fermions.

PMID:41791047 | DOI:10.1103/td98-5ltj

Phys Rev Lett. 2026 Feb 20;136(7):070602. doi: 10.1103/945c-11wt.

ABSTRACT

In the present Letter, we introduce, develop, and investigate a connection between multiphoton quantum interference, a core element of emerging photonic quantum technologies, and Hopfield-like Hamiltonians of classical neural networks, the paradigmatic models for associative memory and machine learning in systems of artificial intelligence. Specifically, we show that combining a system composed of N_{ph} indistinguishable photons in superposition over M field modes, a controlled array of M binary phase shifters, and a linear-optical interferometer, yields output photon statistics described by means of a p-body Hopfield Hamiltonian of M Ising-like neurons ±1, with p=2N_{ph}. We investigate in detail the generalized four-body Hopfield model obtained through this procedure, undergoing a transition from a memory retrieval to a memory black-out regime, i.e., a spin-glass phase, as the amount of stored memory increases. The mapping enables novel routes to the realization and investigation of disordered and complex classical systems via efficient photonic quantum simulators and describes aspects of structured photonic systems in terms of classical spin Hamiltonians.

PMID:41791042 | DOI:10.1103/945c-11wt

Med Sci Sports Exerc. 2026 Mar 3. doi: 10.1249/MSS.0000000000003967. Online ahead of print.

ABSTRACT

INTRODUCTION: The benefits of exercise for cardiovascular disease prevention are well established, yet most patients fail to adopt regular exercise despite healthcare provider recommendations. While healthcare provider recommendations provide interpersonal support, exercise adoption requires the development of intrapersonal motivation and the presence of a supportive environment. The Exercise is Medicine (EIM) program utilizes healthcare provider referrals to connect patients with a community that fosters the translation of exercise beliefs into behaviors. The purpose of this study was to examine the biopsychosocial and behavioral outcomes of the EIM program.

METHODS: Participants were referred by healthcare providers through electronic medical records. Participants engaged in sixteen group sessions and three one-on-one sessions (two before and one after the group sessions) and completed validated measures to assess the biopsychosocial model of health.

RESULTS: The EIM program demonstrated significant improvements in biological and behavioral markers. Notably, exercise participation increased by an average of 64.7 minutes (95% CI: 46.6 to 82.8). Body mass index decreased by 0.48 units (95% CI: -0.63 to -0.32), while perceived stress scores declined by 1.08 points (95% CI: -1.59 to -0.56). Participants also experienced an improvement in health-related quality of life, with general health scores rising by 5.59 points (95% CI: 4.39 to 6.78). Systolic blood pressure decreased by 2.9 mmHg (95% CI: -3.9 to -1.9). Additionally, there was a 22% reduction in depressive symptoms (p < 0.001) and a 9% reduction in perceived stress (p < 0.001). Increases in exercise time were associated with improvements in key behavioral determinants such as self-efficacy, affective judgment/passion, and tolerance.

CONCLUSIONS: Overall, these findings underscore the program’s positive impact on cardiovascular health and mental well-being in a real-world community setting.

PMID:41791037 | DOI:10.1249/MSS.0000000000003967

Retina. 2026 Mar 3. doi: 10.1097/IAE.0000000000004825. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the outcomes of pars plana vitrectomy combined with epiretinal proliferation (EP) embedding and temporal inverted internal limiting membrane (ILM) flap technique in cases of lamellar macular hole (LMH).

METHODS: This retrospective study included data from 17 consecutive patients who underwent EP embedding combined with the temporal inverted ILM flap technique for LMH. The best-corrected visual acuity (BCVA) and optic coherence tomography data were analyzed at baseline and postoperative period.

RESULTS: Anatomic closure was achieved in 100% of patients. The mean baseline and final BCVA were LogMAR 0.53 ± 0.25 (Snellen 20/67) and 0.18 ± 0.19 (Snellen 20/30), respectively, demonstrating a statistically significant improvement (p < 0.001). Furthermore, final BCVA was significantly higher in patients with a preoperative BCVA better than LogMAR 0.5 (Snellen > 20/63) (p =0.001). The central retinal thickness (CRT) improved considerably from 115.5± 40.8 μm preoperatively to 208.4 ± 51.5 μm (p<0.001) at the final visit.

CONCLUSIONS: The EP embedding surgery combined with the temporal inverted ILM flap technique can provide improved anatomical and functional outcomes in patients with LMH. Our findings highlight that early intervention prior to severe visual loss and outer retinal defect development can be further beneficial in LMH cases.

PMID:41791036 | DOI:10.1097/IAE.0000000000004825

Rev Esc Enferm USP. 2026 Feb 27;60:e20250309. doi: 10.1590/1980-220X-REEUSP-2025-0309en. eCollection 2026.

ABSTRACT

OBJECTIVE: To assess the impact of invasive mechanical ventilation on renal function and to verify the predisposing factors for the development of acute kidney injury in relation to the use of invasive mechanical ventilation in intensive care.

METHOD: An observational, retrospective, quantitative cohort study. The sample was non-probabilistic, of convenience, and consisted of 51 patients. Patient severity was assessed using the Simplified Acute Physiology Score and Sequential Organ Failure Assessment. All tests were two-tailed, and p < 0.05 was considered statistically significant.

RESULTS: Among patients with kidney injury on invasive mechanical ventilation, 41.2% presented with severe kidney injury (stage 3 of the Kidney Disease Initiative Global Outcomes). The duration of mechanical ventilation was longer in patients with acute kidney injury compared to those without renal impairment (19 versus four days).

CONCLUSION: The impact of mechanical ventilation in critically ill patients was evidenced by the higher prevalence of severe acute kidney injury. Invasive ventilatory support was more prevalent among older adults, highlighting the severity of the patients based on the Simplified Acute Physiology Score and Sequential Organ Failure Assessment scores, and consequently a higher risk of death.

PMID:41791003 | DOI:10.1590/1980-220X-REEUSP-2025-0309en