Tag: nevin manimala

Surg Endosc. 2026 Jun 12. doi: 10.1007/s00464-026-12951-x. Online ahead of print.

ABSTRACT

BACKGROUND: Despite required simulation training and Fundamentals of Endoscopic Surgery certification, concerns remain about endoscopic competency among graduating general surgery residents. No prior study has directly evaluated resident endoscopic performance in clinical practice. Using the Society for Improving Medical Professional Learning (SIMPL) database, this study assesses general surgery resident competency and autonomy in colonoscopy, upper endoscopy, and sigmoidoscopy/proctoscopy.

METHODS: A retrospective analysis of the SIMPL database was conducted for general surgery residents completing endoscopic procedures between January 2015 and August 2025. Faculty-rated performance was dichotomized as competent (practice-ready/exceptional) versus not competent (unprepared/inexperienced/intermediate performance) and resident autonomy was dichotomized as meaningful (passive help/supervision only) versus not meaningful (show and tell/active help). Descriptive statistics on performance and autonomy were evaluated, including agreement between resident and faculty evaluations. Logistic regression was used to assess resident performance and autonomy according to training year, with case complexity as a covariate.

RESULTS: A total of 3,325 cases were evaluated, consisting of 2,696 colonoscopies, 364 upper endoscopies, and 265 sigmoidoscopies/proctoscopies. Faculty observed competent performance in 35.3% of colonoscopies, 50.0% of upper endoscopies, and 42.3% of sigmoidoscopies/proctoscopies. Faculty observed meaningful autonomy in 60.7% of colonoscopies, 68.9% of upper endoscopies, and 59.2% of sigmoidoscopies/proctoscopies. The likelihoods of achieving competency and meaningful autonomy in the most complex colonoscopies were 23.6% and 40.8%, respectively. At the chief resident level, faculty observed competency in 70.6% of colonoscopies, 89.5% of upper endoscopies, and 87.3% of sigmoidoscopies/proctoscopies.

CONCLUSIONS: Nearly one-third of colonoscopies performed by chief residents did not meet practice-ready competency standards, representing the most concerning finding of this study. Performance was even lower for complex cases, with fewer than one-quarter achieving competency and less than half demonstrating meaningful autonomy. Together, these findings highlight gaps in current training pathways and underscore the need to strengthen endoscopy education.

PMID:42286181 | DOI:10.1007/s00464-026-12951-x

Eur Radiol. 2026 Jun 12. doi: 10.1007/s00330-026-12652-y. Online ahead of print.

ABSTRACT

OBJECTIVE: Though subgroup performance reporting helps ensure the safety of artificial intelligence (AI) products, the extent of this reporting remains unclear. This scoping review identifies studies validating commercially available AI-based products and reports the trends in performance reporting across sex, age, and race/ethnicity demographic subgroups.

MATERIALS AND METHODS: Peer-reviewed validation studies of commercially available products published after 2010 were collected from the Health AI Register and PubMed on 29 November 2024. Study trends in the reporting of sex, age, and race/ethnicity were mapped with regression analysis. We apply the Wilson confidence interval equation to estimate which tuberculosis detection studies are underpowered for subgroup meta-analysis.

RESULTS: Three hundred ninety-two of 545 studies validating 252 products reported subgroup demographic data for any of the three groups. Only 77 of these presented subgroup performance results. Skeletal (20/88) and lung (30/139) studies, and those utilizing chest (24/79) or bone (19/63) radiographs, most often presented subgroup performance data. We found no evidence that more recent studies (OR: 1.039 [95% CI: 0.959-1.127]) or company sponsorship (OR: 1.010 [95% CI: 0.492-1.920]) led to increased subgroup reporting. We show that 14/21 tuberculosis datasets may be underpowered for post-hoc subgroup meta-analysis.

CONCLUSION: This scoping review quantifies how fragmented the commercial validation landscape is, showing that reporting for both the demographics and per-subgroup performance is inadequate for estimating subgroup bias. This systemic problem requires effort from all stakeholders, from researchers to regulatory agencies, encouraging thorough reporting and commercial product validation to support physician and patient trust in medical AI products.

KEY POINTS: Question The number of studies validating the performance of each commercially available radiology AI product for minority subgroup bias is unclear. Findings The currently available commercial AI validation studies often neglect to describe demographic subgroup data, and fewer provide performance results per subgroup, prohibiting algorithmic bias meta-analysis. Clinical relevance Physician and patient trust in the medical AI already used clinically must be built on peer-reviewed literature and meta-analysis. The current literature is insufficient for determining the safety and performance of these products for demographic minorities.

PMID:42286177 | DOI:10.1007/s00330-026-12652-y

Genomics Proteomics Bioinformatics. 2026 Jun 12:qzag046. doi: 10.1093/gpbjnl/qzag046. Online ahead of print.

ABSTRACT

Population admixture is a pivotal evolutionary process that has profoundly shaped genetic diversity and population structure in modern human populations. However, most existing methods for inferring admixture history rely on simplified assumptions, such as strictly sequential contributions from ancestral populations, thereby limiting their applicability to realistic scenarios. Here, we introduce HiMWA, a computational framework based on a hierarchical multiple-wave admixture model for reconstructing complex admixture histories involving multiple ancestral populations. HiMWA characterizes both hierarchical admixture, in which ancestral populations first admix to form intermediate populations, and subsequent multiple-wave admixture that shapes the final admixed population. The framework integrates model selection based on ancestry switch counts with parameter estimation using the length distribution of ancestral tracts. Extensive simulations demonstrate that HiMWA is accurate and robust across diverse admixture scenarios, including those affected by genetic drift and local ancestry inference errors. Applying HiMWA to Kazakhs and Uyghurs revealed a shared hierarchical admixture structure. In both populations, West European and South Asian ancestries first admixed to form a West Eurasian intermediate population, while East Asian and Siberian ancestries formed an East Eurasian intermediate population. These two intermediates subsequently contributed to present-day populations through multiple waves of admixture. Our results highlight the prevalence of hierarchical multiple-wave admixture in Central Asia and provide insights into the region’s complex demographic history. HiMWA offers a powerful and flexible framework for disentangling complex admixture histories and reconstructing realistic population genetic histories from genomic data. The HiMWA software, documentation, and example datasets are publicly available at https://github.com/Shuhua-Group/HiMWA and https://ngdc.cncb.ac.cn/biocode/tool/BT008069.

PMID:42286175 | DOI:10.1093/gpbjnl/qzag046

Commun Psychol. 2026 Jun 12;4(1):95. doi: 10.1038/s44271-026-00487-8.

ABSTRACT

As technology-based learning environments increasingly employ automated feedback, understanding how learners process feedback in real time is essential. This study examined how automated cognitive and metacognitive failure feedback delivered by a humanoid robot affected performance and how effects were moderated by feedback characteristics and learner characteristics. Ninety adults (18-59 years, M_age = 29.53, 61 female, 27 male, 2 diverse) completed a learning task in three conditions: (1) fixed guidance condition with fixed-frequency and content-generic feedback, (2) basic-adaptive condition with frequency-adaptive but content-generic feedback, or (3) personalized-adaptive condition with frequency-adaptive and content-personalized feedback adjusting content to learners specific errors and prior steps. A three-level generalized path model (trials nested within time blocks within learners) was estimated to investigate effects of failure feedback on immediate task performance and cross-level moderation effects. Results showed that cognitive and metacognitive failure feedback increased the likelihood of a correct subsequent response across conditions. Relative to fixed guidance (condition 1), the implemented form of frequency-adaptive feedback (condition 2) did not show statistically significant moderation to these effects. Content-personalized feedback (condition 3) reduced effectiveness of cognitive failure feedback on immediate performance but improved overall performance as compared to content-generic feedback (condition 2). Across conditions, learners with higher cognitive ability benefited less, while those reporting higher momentary on-task boredom benefited more from cognitive feedback. These findings highlight that the effectiveness of automated failure feedback depends on both its design and learners’ situational cognitive and emotional states, illustrating how a situational, temporally sensitive approach can help open the “black box” of feedback effectiveness.

PMID:42286158 | DOI:10.1038/s44271-026-00487-8

Sci Rep. 2026 Jun 12. doi: 10.1038/s41598-026-57254-2. Online ahead of print.

ABSTRACT

Rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) is crucial for early optimization of antibiotic treatment, but current routine susceptibility testing typically requires 48-72 h. Attenuated total reflectance Fourier-transform infrared (ATR-FTIR) spectroscopy has emerged as a promising approach for bacterial identification and has recently been used to distinguish MRSA from methicillin-sensitive S. aureus (MSSA) after 60-120 min of β-lactam exposure. Here, we test whether ATR-FTIR can resolve MRSA versus MSSA within the first hour of antibiotic challenge. We exposed three MSSA (ATCC 6538, WKZ1, RN4220) and four MRSA (ATCC 43300, USA300-JE2, WKZ2, CA629) strains to sub-MIC ampicillin (0.5 μg/mL) and acquired spectra from 800 to 1800 cm^-1 at 0, 20, 30, and 60 min. We compared classification pipelines based on the full spectrum, PCA-reduced features, and LASSO-selected bands, coupled with linear discriminant analysis, partial least-squares discriminant analysis, and support vector machines. Models based on LASSO-selected features achieved the strongest early performance, with strain-aware classification accuracies of 0.91 at 20 min and 0.92 at 30 min. Leave-one-strain-out cross-validation (LOSO-CV) further showed that focusing on mechanistically relevant difference spectra enabled robust across-strain discrimination, with balanced accuracies of 0.91 at 20 min and 0.90 at 30 min. The most informative early bands mapped primarily to peptidoglycan and carbohydrate precursor regions, while later discrimination increasingly involved lipid-associated bands. Transmission electron microscopy and atomic force microscopy at 20 min independently confirmed antibiotic-induced cell-wall thickening and structural disruption in susceptible strains but not in resistant strains. Together, these results establish a proof of concept that early cell-wall stress signatures captured by ATR-FTIR, combined with lightweight and interpretable machine-learning models, can deliver rapid and accurate phenotypic discrimination between MRSA and MSSA.

PMID:42286152 | DOI:10.1038/s41598-026-57254-2

Sci Rep. 2026 Jun 12. doi: 10.1038/s41598-026-57707-8. Online ahead of print.

ABSTRACT

Emergency medical technicians (EMTs) frequently experience workplace violence in prehospital settings; however, evidence on the role of body-worn cameras (BWCs) in this context is limited. This study examined the factors associated with frequent workplace violence, the perceived need for BWCs, and actual BWC use among South Korean EMTs, incorporating individual- and regional-level indicators. A nationwide cross-sectional survey was conducted among EMTs employed by provincial fire departments in South Korea. Survey data on sociodemographic characteristics, work conditions, workplace violence over the past year, and BWC-related perceptions and behaviors were linked to province-level assault indicators from the National 119 emergency medical services (EMS) Statistical Yearbook (2020-2024). The main outcomes included frequent workplace violence, high perceived need for BWCs, and BWC use. Regional assault burden was modeled as tertiles of a five-year mean provincial assault index and as a continuous measure per 10-unit increase. All primary outcomes were self-reported within a knowledge-attitude-practice (KAP) survey design. Multivariable logistic regression was performed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). To address within-province clustering, Generalized Estimating Equations (GEE) were additionally used as a sensitivity analysis. Of 3,595 EMTs included in the descriptive analyses, 2,555 provided complete violence data. Nearly all respondents (99.7%) reported some workplace violence in the past year, and 17.3% were classified as experiencing frequent workplace violence. Overall, 64.4% reported using a BWC, and 87.9% expressed a high perceived need. Frequent violence was associated with younger age, longer EMS career, higher daily call volume, and working as an EMT rather than an ambulance driver, but not with regional assault burden. High perceived need for BWCs was more common among female EMTs and varied by age, again without clear associations with regional assault indices. In contrast, actual BWC use was associated with job position, shorter EMS career, lower call volume, and high perceived need, and was inversely associated with higher regional assault burden. Workplace violence was highly prevalent among South Korean EMTs, and the perceived need for BWCs was widespread. Individual and work-related factors, rather than province-level assault burden, were the key determinants of frequent violence and BWC-related perceptions, whereas BWC use was less common in regions with higher recorded assault indices.

PMID:42286143 | DOI:10.1038/s41598-026-57707-8

Nat Genet. 2026 Jun 12. doi: 10.1038/s41588-026-02641-8. Online ahead of print.

ABSTRACT

Genome-wide association studies in complex polyploids are hindered by genotyping ambiguity and allele dosage complexity. Here we present KMERIA, a k-mer-based framework specifically designed to address these challenges, enabling efficient genotyping and robust association mapping in complex polyploid genomes. Rigorous benchmarking with simulated and empirical datasets demonstrates that KMERIA surpasses existing methods in accuracy and statistical power. By applying KMERIA to 290 wild sugarcane (Saccharum spontaneum) accessions and integrating a 15-accession graph pangenome to capture structural variations, we identified new genes regulating sucrose biosynthesis (SsMGT) and tillering (for example, SsERF14, SsNGA5, SsNAC, SsARF8, SsLOG and SsSCR). These findings elucidate the genetic architecture of yield-related traits and provide actionable targets for sugarcane breeding. Collectively, KMERIA bridges a critical methodological gap in polyploid genomics, while our graph-pangenome integration provides a powerful framework for deciphering genotype-phenotype relationships in crops with complex architectures.

PMID:42286142 | DOI:10.1038/s41588-026-02641-8

Sci Rep. 2026 Jun 13. doi: 10.1038/s41598-026-57018-y. Online ahead of print.

ABSTRACT

This research investigates the influence of shell and inner tube geometry modifications on the thermal performance of latent heat thermal energy storage (LHTES) systems employing phase change materials (PCMs), aiming to overcome the low thermal conductivity and weak melting zones commonly observed in conventional configurations. Several shell-and-tube configurations with circular, rectangular, and trapezoidal geometries were investigated numerically. The novelty of the present study lies in the combined optimization of both shell and inner tube trapezoidal geometries to enhance natural convection and improve heat distribution inside the PCM domain. Numerical simulations evaluate melting time, enhancement ratio, energy storage density, and mean power for each case. Results indicate that the conventional Circle-Circle configuration has the longest complete melting time (CMT) of 5440 s. Fully trapezoidal shell-and-tube designs significantly enhance heat transfer, with Trapezoidal-Trapezoidal 03 achieving a remarkable reduction of 23.53%, lowering the CMT to 4160 s. The enhancement ratio analysis shows that Trapezoidal-Trapezoidal 03 achieves a maximum improvement of 18%, whereas other trapezoidal configurations attain enhancements between 4% and 13%. The superior performance of trapezoidal geometries is mainly attributed to improved heat distribution toward the lower PCM region, reduced thermal dead zones, and stronger natural convection circulation. Regarding energy performance, Trapezoidal-Trapezoidal 03 achieves a mean power of 735 W, while Circle-Trapezoidal 01 and 02 exhibit the highest energy storage densities of 206.24 and 207.88 kJ/kg, respectively. These findings demonstrate that the optimal configuration depends on the targeted application, whether prioritizing rapid melting or higher energy storage density. The present results may contribute to the design of more efficient thermal energy storage systems for solar thermal and industrial waste heat recovery applications.

PMID:42286119 | DOI:10.1038/s41598-026-57018-y

Sci Rep. 2026 Jun 12. doi: 10.1038/s41598-026-56436-2. Online ahead of print.

ABSTRACT

The management of medical insurance funds is pivotal to the development of medical consortia. These funds serve as the operational lifeline of medical consortia and constitute critical public resources essential for public welfare. Medical expense settlement involves multiple stakeholders, including patients, tiered healthcare institutions, and insurance administrative agencies. However, disputes frequently arise between medical insurance authorities and hospitals regarding expense legitimacy due to information asymmetry and interpretative discrepancies. Such conflicts impede smoothness of payment mechanism, thereby undermining consortium operations and inter-institutional collaboration. To address these challenges, this study proposes a blockchain-based framework integrating medical expense investigation with insurance settlement. The system employs two core components: Anomaly detection via the Isolation Forest (IF) algorithm to identify potentially irregular expenses. Consensus-driven adjudication using Fleiss Kappa-based smart contracts facilitated by an anonymous panel of medical experts. This design enhances coordination between expense oversight and settlement processes, thus streamlining dispute resolution for medical expense anomalies and improving the scientific governance of insurance funds. Experimentally, the statistical validity demonstrated for unsupervised anomaly detection of IF and potential engineering applicability indicated in the analysis of healthcare cost. The healthcare consortium blockchain based on a Delegated Proof-of-Stake (DPoS) consensus mechanism and smart contract batch processing achieved a peak throughput of 229.64 transactions per second (TPS) and reduced transaction costs by up to 3,095 gwei. This demonstrates scalability for real-world medical insurance collaborative settlement systems.

PMID:42286116 | DOI:10.1038/s41598-026-56436-2

Int J Obes (Lond). 2026 Jun 12. doi: 10.1038/s41366-026-02112-4. Online ahead of print.

ABSTRACT

BACKGROUND: Investigating early life growth dynamics is important for understanding the developmental origins of obesity. Basis splines (B-splines) provide excellent flexibility for modelling complex growth patterns, but they are prone to overfitting. Penalised B-splines (P-splines) extend B-splines by using a penalty to control their flexibility and avoid overfitting. Despite their advantages, P-splines remain underused in epidemiology, partly due to lack of guidance and accessible software. Our aim was to provide a guide on applying P-spline linear mixed effects models to analyse early life growth trajectories and extract key growth features.

METHODS: We outline the theoretical foundation and fitting procedures for P-splines and illustrate their use on repeated height, weight, and body mass index (BMI) measures up to age 10 years from a Southeast Asian birth cohort (n = 1014). P-splines linear mixed effects models were fitted by reformulating P-splines as mixed models with sparse matrices for efficient estimation. From the fitted trajectories, we estimated infant peak growth velocity, magnitude and timing of infant peak BMI and childhood rebound BMI, and examined their sex differences, intercorrelations, and associations with prenatal factors.

RESULTS: Infant peak height velocity (means:.4.4 vs. 3.9 cm/month) and peak weight velocity (1121 vs. 890 grams/month) was higher in boys than girls. Infancy peak BMI (17.4 vs. 16.8 kg/m²), childhood rebound BMI (15.1 vs. 14.9 kg/m²), age at peak BMI (5.8 vs. 6.4 months), and age at rebound BMI (5.4 years) were comparable between sexes. Ages of peak and rebound BMI had a negligible correlation, higher maternal height was associated with higher peak growth velocity, higher maternal early-pregnancy weight was associated with higher and earlier rebound BMI, and higher birth weight was associated with higher and earlier peak BMI.

CONCLUSIONS: P-splines simplify knot selection, making them a valuable approach for growth modelling. Software, code and datasets are provided to promote uptake of this method.

PMID:42286114 | DOI:10.1038/s41366-026-02112-4