Tag: nevin manimala

J Eval Clin Pract. 2026 Jun;32(4):e70444. doi: 10.1111/jep.70444.

ABSTRACT

RATIONALE: Acutely hospitalised patients may be medically ready for discharge but face psychosocial and other non-medical barriers to returning home. This increases their length of stay and may lead to exposure to hospital associated risks such as hospital-acquired infections. To address these non-medical delays, a transdisciplinary allied health service (the Flying Squad, n = 1.9 Full Time Equivalent professionals) was established at The Royal Melbourne Hospital.

AIMS AND OBJECTIVES: To evaluate the feasibility (demand, implementation, practicality, acceptability and limited efficacy) of this service.

METHOD: A single-site observational study was conducted to determine the demand (number of referrals and patient characteristics including indicators of complexity via the Blaylock Risk Assessment Screening Score; BRASS), implementation (timing of referrals and home visits completed), practicality (case examples, adverse events), acceptability (compliments and complaints) and limited efficacy (estimated number of hospital days saved through the Flying Squad intervention [anticipated minus actual length of stay], discharge destination, hospital length of stay and 28-day readmissions).

RESULTS: Over 12 months, 147 participants were seen by the Flying Squad professionals (median age 64 years [Interquartile Range 51-78 years], 61% male, on day 14 [Interquartile age 7-24] of their hospital admission). Median BRASS scores were 14 (Interquartile Range 9-19] indicating “at risk of requiring extended discharge planning”. Fifty-four home visits were completed for 34 (23%) participants, and one adverse event was reported (fall with no injuries during a home visit). The service won two hospital Awards for Excellence. The median length of hospital stay was 26 [13-45] days; 80 (54%) participants were discharged directly home, and 13 (9%) were readmitted after 28 days. It was estimated that the Flying Squad saved 756 hospital days over 12 months.

CONCLUSION: The Flying Squad was a feasible service that may assist with addressing non-medical barriers to discharge.

PMID:42138035 | DOI:10.1111/jep.70444

Psychol Med. 2026 May 15;56:e155. doi: 10.1017/S0033291726103857.

ABSTRACT

BACKGROUND: Emotion dysregulation is a transdiagnostic construct associated with multiple mental health conditions and shown to be an amenable target for treatment. The original Emotion Dysregulation Inventory (EDI) was created as a proxy-report measure validated in autistic and nonautistic youth. The goal of the current study was to develop a self-report version, the EDI-Self-Report (EDI-SR), that captures a first-person perspective and creates the option of multi-reporter measurement from adolescence through adulthood.

METHODS: Using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS), potential items and response options were written and tested in cognitive interviews. Two samples (996 participants who are autistic or have other intellectual and developmental disabilities and 1,000 participants selected to be representative of the US census as a nonclinical comparison group) completed the initial item pool. Items were assessed using exploratory and confirmatory factor analyses, item response theory analyses, concurrent calibrations, convergent correlations with comparable legacy measures, internal consistency reliability, and test-retest reliability.

RESULTS: Exploratory factor analyses suggested splitting Reactivity and Dysphoria items for confirmatory factor analyses and subsequent analyses. Following analyses, a 25-item Reactivity scale, a 7-item Dysphoria scale, and a 6-item Reactivity short-form scale were finalized. EDI-SR subscales showed convergent validity and superior total information when compared with similar measures, strong internal consistency reliability, and good test-retest reliability.

CONCLUSIONS: The EDI-SR provides an efficient, precise measure of ED in autistic individuals, individuals with other intellectual and developmental disabilities, and a US census-matched representative sample, and allows for multi-reporter assessment in clinical and research contexts.

PMID:42138030 | DOI:10.1017/S0033291726103857

Nurs Open. 2026 May;13(5):e70558. doi: 10.1002/nop2.70558.

ABSTRACT

AIM: To explore longitudinal trajectories of health literacy and identify the associated factors throughout nursing education.

DESIGN: A prospective longitudinal design with a four-year follow-up.

METHODS: The present study was performed at a state university’s nursing department in the capital city of Türkiye. The population consisted of 240 nursing students who studied in the selected faculty between 2015 and 2019. Overall, 191 nursing students were included in the final analysis (n = 191). The data were collected via a questionnaire and the Adult Health Literacy Scale. The first follow-up was performed between September and December 2015. The other three follow-ups were applied 12 months after each participant’s enrollment date, every year from September to December. The data were analysed via the IBM SPSS 25.0 program. Descriptive statistics, Repeated Measures ANOVA, and Linear Mixed Model were used to present the data.

RESULTS: The mean age was 18.49 ± 0.99, and 86.4% were women. Of the students, 50.8% lived in an urban area, 97.9% were internet users, 38.7% had visual impairment, and 38.2% had glasses. A statistically significant difference existed between the health literacy mean scores over time. Nursing students’ health literacy levels decreased among rural area residents and increased among students who had no vision problems and were internet users.

CONCLUSIONS: This study suggests that the health literacy levels of nursing students increased during the education period. Internet use, place of residence, and having a visual problem affected the alterations in health literacy levels over time.

RELEVANCE TO CLINICAL PRACTICE: Findings can be a valuable resource for nurse educators and faculty managers to produce effective strategies to increase the health literacy level of prospective nurses.

PATIENT AND PUBLIC CONTRIBUTIONS: It was not appropriate or possible to involve patients or the public in the design, conduct, reporting, or dissemination plans of our research.

PMID:42138014 | DOI:10.1002/nop2.70558

Clin Physiol Funct Imaging. 2026 May;46(3):e70067. doi: 10.1111/cpf.70067.

ABSTRACT

BACKGROUND: Peak expiratory flow (PEF) obtained from dedicated PEF meters and various types of spirometers is often used interchangeably in research, despite differences in both devices and expiratory maneuver technique. The aim of this study was to assess the effects of expiratory maneuver type and measurement device on PEF.

METHODS: We recruited 20 healthy adults experienced in performing spirometry. Each subject performed three measurements using two expiratory maneuvers (a short, explosive maneuver and a long, spirometry-style maneuver) with four devices: the handheld microspirometers Medikro Duo and MIR Spirobank, the laboratory spirometer Vyntus Pneumo, and the Mini-Wright PEF meter.

RESULTS: PEF differed significantly between devices (F(3,133) = 171.8, p < 0.001), but not between short and long expiratory maneuver techniques (F(1,133) = 2.24, p = 0.137). There was no significant interaction between device and technique (F(3,133) = 0.72, p = 0.543). Compared with the Mini-Wright, Spirobank yielded PEF values that were on average 87.1 L/min higher (74.6-99.7, p < 0.001), and Vyntus Pneumo 26.5 L/min higher (14.0-39.1, p < 0.001), whereas Medikro did not differ significantly from the Mini-Wright (mean difference -9.5 L/min, -22.1-3.1, p = 0.269). The pairwise differences between the three spirometers were all statistically significant (all p < 0.001).

CONCLUSIONS: Because short and long expiratory maneuver techniques yield similar results on PEF, future studies of home spirometry may compare the diagnostic performance of PEF and forced expiratory volume in 1 s (FEV₁) using the same long, spirometry-style expiratory maneuvers. However, comparison of absolute PEF values between devices must be done cautiously.

PMID:42138012 | DOI:10.1111/cpf.70067

Ginekol Pol. 2026;97(4):272-278. doi: 10.5603/gpl.108254.

ABSTRACT

OBJECTIVES: To assess long-term efficacy and safety of uterine artery embolization for symptomatic uterine fibroids.

MATERIAL AND METHODS: This retrospective cohort study included women undergoing uterine artery embolization for symptomatic fibroids from 2012 to 2023. A validated questionnaire assessed symptoms (e.g., heavy menstrual bleeding, pelvic pain) pre- and post- uterine artery embolization. Data on fibroid characteristics, follow-up duration, menopause status, and complications were collected. Patients were stratified into follow-up terciles. Statistical analyses included Wilcoxon signed-rank tests, linear regression with menopause adjustment, and Spearman correlations tests (p < 0.05).

RESULTS: Uterine artery embolization significantly reduced symptoms, particularly bleeding-related complaints, with sustained efficacy across short-, mid-, and long-term follow-up, even after menopause adjustment. Menopause enhanced symptom relief. No correlations were found between symptom reduction and age, fibroid size, or prior treatment. Complications, mostly minor, occurred in a notable proportion, with rare major events. A small subset achieved successful pregnancies post-embolization.

CONCLUSIONS: Uterine artery embolization is an effective, minimally invasive treatment for fibroid-related symptoms, with sustained benefits over time; menopause significantly predicts greater symptom improvement.

PMID:42138001 | DOI:10.5603/gpl.108254

J Genet Couns. 2026 Jun;35(3):e70220. doi: 10.1002/jgc4.70220.

ABSTRACT

Genetic counseling assistants (GCAs) support genetic counselors (GCs) and genetics clinic workflows, but their potential roles in pretest genetic counseling for rare diseases have not been explored. A pilot within the Mayo Clinic Center for Individualized Medicine’s Genetic Testing and Counseling Clinic (GTAC), which offers predefined tests for patients with rare disease, explored the impact of GCA pretest education on appointment time and patient questions. After training, GCAs met GTAC patients prior to the GC to provide scripted information on genetics concepts, the visit purpose, and the test including result types and disclosure plans. Data from the pilot and a control group were collected and analyzed using descriptive statistics and two-sided t-tests. Patient cohort characteristics did not differ between the two models. When a GCA provided pretest education, the GC spent an average of 11.2 minutes less with the patient during their session compared to visits completed solely by the GC (p < 0.0001). Total appointment time was not impacted by GCA education. Questions asked to GCAs were often not within GCA scope to answer (72.7%), and some patients asked repetitive questions to both the GC and GCA (63.2%). Reduction in GC time per patient could lead to increased accessibility by allowing additional patients to be seen in a day. Similar models may support GCA professional development while allowing GCs to remove repetitive education from their genetic counseling sessions, leading to less burnout and/or increased job satisfaction. Impact on administrative workflows, access, revenue, patient satisfaction and outcomes and GC/GCA satisfaction and benefits can continue to be explored when trialing models incorporating GCAs in pretest education roles.

PMID:42137995 | DOI:10.1002/jgc4.70220

Nucleic Acids Res. 2026 May 5;54(9):gkag466. doi: 10.1093/nar/gkag466.

ABSTRACT

Spatial transcriptomics (ST) unlocks potential for studying gene functions in processes that depend on orchestration of transcription across space. However, analysis tools for ST remain aimed at data exploration, with few resources for hypothesis testing. What’s missing is a way to test whether a factor of interest affects functionally relevant parameters of a gene’s spatial distribution. We present a tool to fill this gap, which we call a warped sigmoidal Poisson-process mixed-effects (WSP, pronounced “wisp”) model. WSP models are the first ST tool allowing researchers to test critical questions without bespoke preprocessing pipelines for identifying key spatial parameters. By aligning coordinates to an axis of interest and letting a likelihood-based regression find between-group effects on expression rates and boundaries, WSP models replace error-prone manual preprocessing with minimally biased hypothesis testing. After introducing WSP models, we demonstrate their statistical validity using semi-synthetic simulated data and their ability to test for effects by applying them to MERFISH data from mouse somatosensory cortex and bulk sequencing data from mouse liver lobules with extrapolated spatial coordinates. Together, these validations and applications demonstrate that WSP models offer a practical and statistically rigorous approach to quantifying and testing for effects on spatial variation in transcriptomic data.

PMID:42137981 | DOI:10.1093/nar/gkag466

Palliat Support Care. 2026 May 15;24:e146. doi: 10.1017/S1478951526102247.

ABSTRACT

INTRODUCTION: Depression in cancer patients is a common condition that poses significant challenges for prognosis, treatment adherence, and quality of life. Its onset reflects the interplay of diverse biological, psychological, and social factors, which has been the focus of numerous studies.

METHODS: We identified both systematic and non-systematic reviews examining cross-sectional or prospective studies reporting associations between DAFs and depression. We extracted data relative to DAFs, as well as the direction and statistical significance of the reported association. Consistency of findings was assessed by estimating the proportion of concordant studies (PCS) for each DAF. Methodological quality and risk of bias were assessed using a standardized tool.

RESULTS: We identified 73 reviews (26 systematic and/or meta-analyses, 47 narrative) encompassing 514 unique primary studies, reporting the associations between depression and 198 distinct DAFs. DAFs were grouped into six domains (sociodemographic, cancer-related, somatic, psychological, biological-genetic, and other). The strongest associations (PCS ≥ 75% and ≥5 studies) were observed for sociodemographic factors (e.g., high social support, being unmarried), inflammatory markers (IL-6, TNF-α, CRP), psychological factors (e.g., history of depression, distress, anxiety), and somatic factors (e.g., fatigue, low functional status, malnutrition). When restricting analyses to prospective studies, consistent associations emerged for cancer-related physical symptoms and time dedicated to patient communication.

CONCLUSIONS: Depression in cancer is multifactorial, with physical and psychosocial factors likely iteracting dynamically. Prospective studies are still greatly needed. Further research on risk and protective factors may facilitate risk stratification, early diagnosis and patient management.

PMID:42137975 | DOI:10.1017/S1478951526102247

Health Serv Res. 2026 Jun;61(3):e70121. doi: 10.1111/1475-6773.70121.

ABSTRACT

OBJECTIVE: To evaluate whether payment reductions achieved during the Oncology Care Model (OCM) continued after the model ended.

STUDY SETTING AND DESIGN: OCM was a voluntary episode-based alternative payment model designed to improve the value of care for Medicare beneficiaries receiving chemotherapy for cancer. Participating practices received $160 monthly care coordination payments and could receive shared savings (or penalties) according to quality and spending goals during 6-month episodes. We extended the OCM regression-adjusted difference-in-differences (DID) payment analysis by 18 months after the model’s conclusion to assess sustained effects on total episode payments (TEP) and component Parts A, B, and D, and Part B drug payments.

DATA SOURCES AND ANALYTIC SAMPLE: We used Medicare administrative data, model program data, and secondary sources describing market and provider characteristics to analyze 6-month chemotherapy episodes for Medicare fee-for-service beneficiaries initiated during January 2014-July 2015 (baseline), July 2016-December 2021 (performance), and January 2022-June 2023 (post-performance).

PRINCIPAL FINDINGS: In the 18 months following OCM’s end, on average, OCM practices reduced TEP by -$955, driven by significant reductions in Part B payments (-$559). Part B payment reductions were primarily for non-chemotherapy drugs (-$489). Overall payment reductions totaled $328 million. Sustained payment reductions were predominantly among practices adopting two-sided risk; these practices reduced TEP by $3379, including significant reductions in Parts A (-$738), B (-$1370), and D (-$1112) payments.

CONCLUSION: OCM savings following the model’s end were driven by practices that adopted two-sided risk. These sustained payment reductions after OCM’s conclusion provided substantial additional savings for CMS, reducing estimated model losses from $639 million to $311 million.

PMID:42137948 | DOI:10.1111/1475-6773.70121

Int J Biostat. 2026 May 15. doi: 10.1515/ijb-2024-0034. Online ahead of print.

ABSTRACT

The prognostic score (PGS) is a function of observed covariates that summarizes covariates’ association with potential responses. In the current study, we propose a full prognostic score (FPGS), an extension of the PGS that integrates individual prognostic scores to account for confounding adjustments in causal inference. Under effect modification, we show that FPGS and a version of FPGS using conditional expectations of the outcomes, meet the sufficiency condition for confounding adjustment to estimate the average causal effect. We present a general algorithm to implement the FPGS approach for estimation by applying linear regression, random forest regression, and XGBoost regression. When determining the average causal effect, we incorporate FPGS into semiparametric estimators including regression imputation, simple stratification, and targeted maximum likelihood estimation (TMLE). The finite-sample properties of the estimators are compared through three simulation studies. Based on the findings of the FPGS estimators, the mean squared error of the linear regression imputation estimator and the TMLE estimator comprised of linearly regressed PGS is smaller than the mean squared error of alternative estimators. In an empirical study, we analyze data from the National Health and Nutrition Examination Survey (NHANES, 2007-2008) to determine the effect of smoking on blood lead levels.

PMID:42137947 | DOI:10.1515/ijb-2024-0034