Tag: nevin manimala

Prev Vet Med. 2026 May 17;254:106916. doi: 10.1016/j.prevetmed.2026.106916. Online ahead of print.

ABSTRACT

INTRODUCTION: This review evaluates the effectiveness of culling and birth control interventions for managing free-roaming dogs (FRD) and cats (FRC) worldwide across key outcome domains-population metrics, zoonotic disease indicators, shelter indicators, public metrics, animal welfare, ecological externalities, and cost-effectiveness-and identifies contextual conditions determining intervention effectiveness.

METHODS: Following PRISMA, we conducted three separate systematic searches in PubMed, Web of Science, and Scopus (up to 16 October 2025) addressing culling, birth control, and modelling studies. Empirical evidence was synthesised using descriptive, stratified analyses. Modelling studies were synthesised to identify conditions associated with effectiveness.

RESULTS: Ninety-one empirical studies were included (33 culling; 58 birth control), alongside 18 modelling studies. Birth control interventions were more frequently classified as effective than culling, with statistically significant differences in effectiveness distributions between intervention types (p = 0.045). Culling effectiveness was context-dependent and largely confined to island systems, particularly for FRC, while FRD-targeted culling was rarely effective, especially for zoonotic disease indicators and public metrics. Birth control-particularly multi-component, long-term programmes-showed higher effectiveness across domains and in open mainland settings. Temporal analyses showed a decline in both the volume and reported effectiveness of culling studies since 2010, alongside increasing and geographically broader evidence for birth control. Modelling studies identified high population coverage, sustained implementation, and control of population inflow as key conditions for effectiveness.

CONCLUSIONS: Culling has limited, context-dependent effectiveness, whereas birth control within integrated strategies more consistently achieves sustained outcomes across domains. Effectiveness depends on coverage, duration, and addressing drivers of population inflow, including abandonment and uncontrolled breeding.

PMID:42166825 | DOI:10.1016/j.prevetmed.2026.106916

JMIR Res Protoc. 2026 May 21;15:e87165. doi: 10.2196/87165.

ABSTRACT

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant global health concerns, particularly prevalent in low- and middle-income countries (LMICs). In China, a significant number of international migrants from LMICs reside, many of whom are at high risk of HBV and HCV infection, while this group tends to engage in low HBV and HCV test use due to some adverse factors. Pay-it-forward (PIF) is a social innovation strategy that is based on the theories of upstream reciprocity and mutual aid. Previous studies have shown that the PIF strategy has proven effective in promoting sexually transmitted infections (STIs) testing in various populations.

OBJECTIVE: This study aims to evaluate the effectiveness of a PIF intervention in promoting HBV and HCV testing among international migrants from LMICs in China.

METHODS: A 2-arm cluster randomized controlled trial (RCT) will be conducted in Guangzhou, China. Participants will be recruited from a public hospital serving a large migrant community. A total of 100 eligible participants will be enrolled in blocks of 5 using a cluster randomization plan and randomly assigned to either the PIF intervention arm or the control arm in a 1:1 ratio. Participants in the intervention arm will watch a 2-minute video introducing the PIF concept and receive printed educational materials on HBV and HCV. Participants will then be offered free testing donated by previous participants, which they can accept or decline, and an opportunity to make a monetary donation to cover testing for a future participant. Control arm participants will receive standard medical services, with self-paid testing. The primary outcome is the proportion of participants tested for both HBV and HCV. Data will be collected through a self-administered questionnaire, and test information will be obtained from the hospital’s medical records without personally identifiable information. The survey data will be analyzed using generalized estimating equations to account for clustering effects.

RESULTS: This protocol was completed in August 2024, and implementation was conducted from September 2024 to February 2025. According to the baseline survey findings, 73.0% (73/100) of the 100 eligible participants recruited were male, 87.0% (87/100) were from African countries, and 85.0% (85/100) came to China for business purposes. About 40.0% (40/100) earned more than US $1100 per month, 62.0% (62/100) were married, and 6% (6/100) had both stable and casual sexual partners.

CONCLUSIONS: This study is innovative in targeting international migrants from LMICs in China and using the PIF strategy to promote HBV and HCV testing. The PIF intervention is expected to increase testing rates by addressing financial barriers and fostering community support. The findings will contribute to the understanding of HBV and HCV testing promotion among this understudied population, with potential implications for public health policy and practice.

PMID:42166794 | DOI:10.2196/87165

JMIR Mhealth Uhealth. 2026 May 21;14:e70188. doi: 10.2196/70188.

ABSTRACT

BACKGROUND: Dementia has an impact on the physical activities performed daily in a social context. Sleeping and resting, in general, are also affected by dementia. Monitoring techniques based on miniaturized wearable sensors and on sensorized environments allow for actigraphic recordings and location tracking. The availability of contemporaneous physical activities profile led to quantify, in the social actigraphy approach, the level of correlation between individuals living in the same environment.

OBJECTIVE: This study has two main objectives: (1) to define a methodology for actigraphic recordings, based on wearable accelerometers, and on location tracking, based on Bluetooth wearable technology, and to apply it in a well-defined social context, a long-term care residential unit for people with dementia; and (2) to quantify test-retest reliability of the indices obtained by the monitoring methodology.

METHODS: Persons with dementia living in the long-term care unit have been equipped with miniaturized wearable sensors, an accelerometer at their dominant wrist, and a Bluetooth beacon at their ankle for 7 days. The raw recordings allowed for computing indices related to physical activity intensities, to the occurrence of walking bouts, to the efficiency of sleep and waking phases, to social interactions between individuals, and to locations preferably occupied. The 7-day session was repeated at short (3 weeks) and long (3 months) terms in order to quantify the test-retest reliability of the indices.

RESULTS: Twenty-five persons with dementia were enrolled, 4 of them dropped out, and valid data were obtained, in the different sessions, from 19 to 21 individuals of the recruited group. Control data from 10 age-matched healthy participants were derived from published datasets. As a group, compared with age-matched healthy participants, persons with dementia showed a comparable duration of phases of no activity and of light activity (energy cost lower than 3 metabolic equivalents of tasks [METs]), a relevantly lower duration (-84.3%) of phases of moderate activity (energy cost ranging from 3 to 6 METs), and substantial absence (-100%) of phases of vigorous activity (larger than 6 METs); moreover, daytime and nighttime were characterized by comparable wake and sleep, respectively, efficiency; finally, as to the social interactions, persons with dementia showed a lower correlation of their motor activity profiles (-53.1%). The test-retest reliability was excellent for physical activity indices (intraclass correlation coefficients ranging from 0.76 to 0.98), good for social indices (0.65-0.67), excellent for sleep or wake efficiency (0.74-0.89), and fair for location tracking indices (0.37-0.78).

CONCLUSIONS: The considered methodology, particularly concerning accelerometry, proved to be feasible, informative, and with a good to excellent test-retest reliability. Interestingly, the methodology clearly identified behaviors, such as wandering, in a minority of individuals inside this study’s group of persons with dementia, thus supporting a possible clinical use of the methodology.

PMID:42166790 | DOI:10.2196/70188

J Med Internet Res. 2026 May 21;28:e83896. doi: 10.2196/83896.

ABSTRACT

BACKGROUND: Alcohol use disorder (AUD) profoundly affected ethnic minority young adults due to unique stressors, such as acculturation challenges and discrimination. Our prior studies found that experiential avoidance behavior and discrimination significantly contributed to AUD. These findings warranted third-wave interventions, such as acceptance and commitment therapy (ACT). Nonetheless, barriers to engagement with value-based activities may affect ACT efficacy. Behavioral activation (BA) may be an alternative for this shortcoming. Integrating these interventions has shown promise. However, no studies evaluated its effectiveness in this group. Therefore, evaluating the preliminary effectiveness and feasibility of this intervention was needed.

OBJECTIVE: This study aimed to evaluate the feasibility measures. The secondary objective aimed to examine its effectiveness on cumulative abstinence duration, drinking days, drinks per drinking day, heavy drinking days, alcohol abstinence self-efficacy, readiness to change, psychological flexibility (Acceptance and Action Questionnaire-version II), and everyday discrimination score.

METHODS: A pilot parallel randomized controlled trial was conducted. Forty young ethnic minorities who can speak English and have AUD based on DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) criteria were recruited and randomly assigned to either Acceptance and Commitment Therapy with Behavioral Activation (ACT-BA; n=20) or Treatment-as-Usual (TAU; n=20) using a computer-generated random number; assessors were blinded to group assignment. Outcomes were collected at baseline (T0) and postintervention (T1). The analysis included descriptive statistics, independent samples t test, chi-square test, and generalized estimating equations with multiple imputations. To further supplement findings, a qualitative interview was conducted.

RESULTS: A total of 148 ethnic minority young adults were screened, with an eligibility rate of 38.5% (57/148). Of these, 85.9% (49/57) consented, and among them, 81.6% (40/49) were randomized to either the ACT-BA or TAU. The retention rate was 82.5% (33/40), of which 75% (30/40) completed the postintervention assessment (ACT-BA: 16/20, 80%; TAU: 14/20, 70%). The adherence rate was 81.7% (4.9/6 sessions), and participants reported no adverse effects. Finally, 40 participants (20 for each group) were analyzed. The intervention group showed a promising improvement in drinking days (B=-4.12, 95% CI -8.10 to -0.13; P=.04, d=-0.57), drinks per drinking day (B=-1.56, 95% CI -3.06 to -0.07; P=.04, d=-1.89), alcohol abstinence self-efficacy (B=11.95, 95% CI 0.10-23.81; P=.048, d=0.81), and Acceptance and Action Questionnaire-version II (B=-6.41, 95% CI -12.77 to -0.06; P=.04, d=-0.65).

CONCLUSIONS: This study, unlike existing evidence, presents an innovative integration of ACT and BA delivered via an internet-based self-help format. The findings contribute to the field by providing preliminary evidence that this integrated intervention is feasible and promising for AUD. The main implication in the real world is to conduct a fully powered randomized controlled trial to further examine its effectiveness with longer follow-up to serve as a stand-alone treatment option for ethnic minorities.

PMID:42166789 | DOI:10.2196/83896

J Med Internet Res. 2026 May 21;28:e87216. doi: 10.2196/87216.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that reduces quality of life and causes a heavy medical burden. Internet-based self-help interventions are flexible and scalable, showing potential for IBS symptom improvement, but relevant evidence is fragmented and lacks systematic review.

OBJECTIVE: This systematic review aimed to comprehensively evaluate the effects of internet-based self-help interventions on symptom severity, quality of life, and visceral sensitivity, as well as comorbid depressive and anxiety symptoms, in individuals with IBS.

METHODS: Only randomized controlled trials evaluating internet-based self-help interventions for individuals with IBS were included. A literature search was conducted across PubMed, Embase, Web of Science, CINAHL Complete, PsycINFO, the Cochrane Library, and 4 Chinese databases on June 25, 2025, with an updated search on March 9, 2026. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Meta-analyses were performed with the Hartung-Knapp-Sidik-Jonkman-adjusted random-effects model. Effect sizes were reported as standardized mean differences (SMDs) with 95% CIs, and evidence certainty was evaluated using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria.

RESULTS: A total of 17 randomized controlled trials from 7 countries were included, involving 2289 participants (predominantly female). Compared with control groups, internet-based self-help interventions were associated with a statistically significant improvement in IBS symptom severity (SMD -0.52, 95% CI -0.78 to -0.26, 95% prediction interval [PI] -1.46 to 0.42), quality of life (SMD 0.57, 95% CI 0.23 to 0.90, 95% PI -0.41 to 1.54), visceral sensitivity (SMD -0.55, 95% CI -0.89 to -0.21, 95% PI -1.43 to 0.33), and depressive symptoms (SMD -0.14, 95% CI -0.27 to -0.01, 95% PI -0.27 to -0.01). However, no statistically significant improvement was observed in anxiety symptoms (SMD -0.03, 95% CI -0.34 to 0.27, 95% PI -0.78 to 0.71). The certainty of evidence was rated as moderate to very low for all outcomes.

CONCLUSIONS: This review synthesizes the latest evidence on internet-based self-help interventions for individuals with IBS disease-specific and comorbid psychological symptoms. It stands out by encompassing a diverse range of such interventions and incorporating visceral sensitivity as a key outcome. In doing so, it establishes a more comprehensive multi-outcome evidence base for IBS digital interventions, advancing the field by clarifying the potential of these interventions as viable alternatives to conventional treatments. For real-world practice, these findings can inform targeted strategies for primary care and telemedicine platforms, especially in resource-limited regions. However, this review is limited by moderate bias risk, high heterogeneity, and moderate to very low GRADE evidence certainty. A wide 95% PI suggests that effect variability is linked to contextual and population factors, so findings should be interpreted cautiously. Future research should prioritize technical support, patients’ digital health literacy, and standardized intervention protocols to further validate clinical utility.

PMID:42166786 | DOI:10.2196/87216

JMIR Hum Factors. 2026 May 21;13:e60551. doi: 10.2196/60551.

ABSTRACT

BACKGROUND: Telemedicine has rapidly expanded; however, standardized, telemedicine-specific patient-reported experience measures tailored to outpatient workflows are limited in many settings.

OBJECTIVE: This study aimed to develop and psychometrically validate the Telemedicine Service Experience Questionnaire (TSEQ) for Chinese outpatients using telemedicine services.

METHODS: We conducted a web-based survey among outpatients who completed a telemedicine consultation at Peking Union Medical College Hospital between July 1, 2021, to August 31, 2021, and who had used telemedicine services, using an adapted Chinese Patient Experience Questionnaire that encompasses 15 questions across 4 dimensions, to investigate patients’ telemedicine consultation experiences. Item generation was informed by a literature review, workflow mapping, and expert review. We evaluated the factor structure using exploratory factor analysis and confirmatory factor analysis on the full sample with cross-validation. Reliability was assessed using Cronbach α and item-total correlations.

RESULTS: In total, 3338 participants completed the survey (mean age 45.3, SD 17.8 y; n=2182, 65.4% female participants; n=1827, 54.8% with college education or above). The exploratory factor analysis of the final 14-item scale resulted in 4 factors. After scrutinizing the content, these factors were labeled “Service Efficiency,” “Post-treatment,” “Information Guidance,” and “Humanistic Care,” and they demonstrated good internal consistency (Cronbach α values of 0.876, 0.840, 0.962, and 0.876, respectively). Moreover, as the average variance extracted values were greater than 0.5 and the composite reliability values were greater than 0.7, the TSEQ scale has high convergent validity. Our findings suggest that the psychometric properties of the 14-item TSEQ are valid and reliable for assessing telemedicine service experience among Chinese outpatients.

CONCLUSIONS: The TSEQ demonstrates a stable multidomain structure with satisfactory reliability and validity for evaluating outpatient telemedicine service experience in China. The instrument can support routine quality monitoring and guide targeted workflow improvements. Future studies should validate the TSEQ in multisite and postpandemic samples and examine measurement invariance across key subgroups.

PMID:42166784 | DOI:10.2196/60551

J Chem Inf Model. 2026 May 21. doi: 10.1021/acs.jcim.6c00481. Online ahead of print.

ABSTRACT

Nuclear magnetic resonance (NMR) structure determination is an important problem in education, industry, and research. Solving NMR spectra requires expert knowledge, critical thinking, and careful evaluation of multiple features of spectral data. This study explores the capabilities of large language models (LLMs) and large reasoning models (LRMs) for solving NMR spectral tasks. We selected 112 problems from NMR-Challenge.com, which has been used by students practicing NMR structure elucidation, collecting >1 million human responses, and developed a plain text problem format for evaluating LLM reasoning in this domain. We evaluated 10 LLMs (GPT-4o, GPT-4o-mini, o1, o1 mini, o3 mini, Claude-3.5 Sonnet, Gemini 2.0 Flash, Meta Llama 3, ChemDFM-R, and ether0), comparing 5 prompts to spur chain-of-thought reasoning in different ways, especially comparing the influence of providing background NMR chemistry knowledge, reasoning strategy, or both. Newer models trained to emphasize reasoning performed better, and increasing reasoning effort led to modest improvements, but prompting and varying temperature did not have an effect. We also evaluated undergraduate organic chemistry students in a controlled setting and analyzed answer submission statistics from global submissions to NMR-Challenge.com, to characterize human performance on these problems. The top-performing students surpassed smaller models like GPT-4o by 24%, 33%, and 29% on the Easy, Moderate, and Hard sets, respectively. However, reasoning models like o1 exceeded student performance by 13%, 14%, and 19%, respectively. Patterns in mistakes made by humans and LLMs reveal that errors made by LLMs are similar to those typically made by humans, for instance, incorrect positioning of substituents on benzene and incorrect orientation of carboxyl groups in esters. However, LLMs still “think” differently from humans, in some cases, providing answers that no human submitted via the website. This work also illustrates how NMR spectral problems can be used to benchmark LLMs on reasoning-heavy tasks in chemistry, though for this particular set of problems, early 2025 LLMs already exceed undergraduate student performance.

PMID:42166780 | DOI:10.1021/acs.jcim.6c00481

Health Rep. 2026 May 20;37(5):15-25. doi: 10.25318/82-003-x202600500002-eng.

ABSTRACT

BACKGROUND: Breast cancer is the most commonly diagnosed cancer among women in Canada. Breast density substantially influences breast cancer risk and mammography performance. However, OncoSim-Breast, a Canadian microsimulation model representing breast cancer control, including cancer onset, screening, and survival, has not previously explicitly accounted for breast density. This study describes the incorporation of density-specific parameters into the OncoSim-Breast model.

DATA AND METHODS: Breast density-specific inputs were integrated into OncoSim-Breast using data from five Canadian provinces. Three key parameters – prevalence, relative risk of breast cancer, and digital mammography performance (sensitivity and specificity) – were estimated by age group and breast density category, following the American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS) classification (categories A to D). Calibration experiments and internal validations were conducted to ensure the updated OncoSim-Breast model aligned with observed data from the Canadian Cancer Registry.

RESULTS: The prevalence of dense breasts declined with age: BI-RADS categories C and D accounted for 58% of women younger than 50 years and 26% of those aged 70 and older. Digital mammography sensitivity also decreased with increasing density: among women younger than 50 years, sensitivity was 88% for Category A and 69% for Category D. The updated OncoSim-Breast model accurately replicated age-specific incidence, age-adjusted incidence, and stage distribution based on historical data from the Canadian Cancer Registry (2010 to 2019).

INTERPRETATION: Incorporating breast density-specific parameters substantially improved the accuracy and policy relevance of OncoSim-Breast. The updated model provides a validated tool to inform screening policy decisions for Canadian women, allowing consideration for the effect of the variability of breast density among women.

PMID:42166779 | DOI:10.25318/82-003-x202600500002-eng

Health Rep. 2026 May 20;37(5):3-14. doi: 10.25318/82-003-x202600500001-eng.

ABSTRACT

BACKGROUND: Previous work has noted variability in cancer incidence and cancer-related outcomes according to place of residence. This study examined geographic variability in the incidence and mortality of breast cancer among females in Canada.

DATA AND METHODS: Data from the 2021 Canadian Cancer Registry (breast cancer incidence) and the Canadian Vital Statistics – Death database (breast cancer mortality) were examined across provinces and territories, community sizes, and peer groups (i.e., clusters of health regions with similar socioeconomic and demographic characteristics). Age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) per 100,000 females per year and their rate ratios were calculated, as well as age group-specific and age-standardized stage-specific incidence rates.

RESULTS: From 2010 to 2020, the invasive breast cancer ASIR was 140.1 per 100,000 females annually, with marked geographic and community variation. Mean age at diagnosis was 62.7 years, and it was lowest in northern and remote regions. Three-quarters of cases were stages I and II, though stage-specific ASIRs varied. Overall ASIRs were highest in peer groups B (urban centres with large immigrant and racialized populations) and D (rural regions in Quebec, Ontario and the Prairies). They were lowest in peer groups F (Northern and remote regions with young populations), G (Montréal, Toronto, and Vancouver), and H (urban centres in Ontario and British Columbia). From 2010 to 2022, the ASMR was 28.3 per 100,000, highest in rural Eastern Peer Group E and lowest in large urban centres.

INTERPRETATION: The study found significant variability in female breast cancer incidence and mortality across the geographical classifications considered, highlighting the need for a closer look at regional- and individual-level factors and their respective associations with cancer incidence and outcomes.

PMID:42166778 | DOI:10.25318/82-003-x202600500001-eng

JMIR Mhealth Uhealth. 2026 May 21;14:e87628. doi: 10.2196/87628.

ABSTRACT

BACKGROUND: Frailty is highly prevalent in survivors of multiple myeloma (MM) after autologous hematopoietic cell transplantation and is associated with poor functional recovery and adverse clinical outcomes. Although exercise is known to improve physical function, traditional center-based rehabilitation models are often inaccessible to this population during early posttransplant recovery. Mobile health (mHealth)-supported exercise may offer a scalable alternative; however, evidence in hematologic malignancies remains limited.

OBJECTIVE: This study aimed to evaluate the effects of a 16-week mHealth-supported exercise rehabilitation program on frailty phenotype and physical function in survivors of MM within 180 days after autologous hematopoietic cell transplantation.

METHODS: In this single-center randomized controlled trial, participants who self-reported as prefrail or frail were randomized 1:1 to an mHealth-supported exercise group (n=16) or usual care control (n=16). Remote assessments were conducted at baseline (week 0), midpoint (week 9), and follow-up (week 17). The intervention consisted of 8 weeks of supervised tele-exercise (3 sessions/week, 50 minutes/session), followed by 8 weeks of independent home-based exercise using the same mHealth platform. Exercise intensity was prescribed using a repetitions-in-reserve-based rating of perceived exertion approach with symptom-guided progression. The primary outcome was change in the 5-component Fried frailty phenotype score (0-5). Secondary outcomes included Short Physical Performance Battery components, chair stand time, gait speed, and handgrip strength. Intention-to-treat analyses were conducted using generalized estimating equations to evaluate between-group differences over time.

RESULTS: Participants had a mean age of 64.6 (SD 7.1) years and were enrolled a mean of 136 (SD 36.3) days posttransplant. At baseline, 94% (30/32) of participants were classified as frail. Adherence to the supervised sessions was 85% (326/384 sessions), and adherence during the unsupervised phase was 78% (298/384 sessions). The exercise group demonstrated a significantly greater reduction in frailty score compared with control from baseline to week 17 (P<.001). Between-group difference estimates showed a clinically meaningful improvement favoring exercise at both week 9 and week 17 (P<.001). Chair stand time improved significantly in the exercise group compared with control, with faster completion times observed at week 9 and sustained through week 17 (P=.002). Improvements in other Short Physical Performance Battery components and handgrip strength favored the exercise group but did not reach statistical significance. No serious adverse events occurred.

CONCLUSIONS: A 16-week mHealth-supported, progressively prescribed exercise rehabilitation program was feasible, safe, and effective in reversing frailty phenotype and improving functional mobility in survivors of MM early after autologous transplantation. This approach provides a scalable model for delivering structured rehabilitation during a high-risk recovery window. Larger trials incorporating attention-matched controls and longer follow-up are warranted.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05142371; https://clinicaltrials.gov/study/NCT05142371.

PMID:42166768 | DOI:10.2196/87628