Tag: nevin manimala

JMIR Hum Factors. 2026 Apr 22;13:e78939. doi: 10.2196/78939.

ABSTRACT

BACKGROUND: Mobile health (mHealth) apps are increasingly used to support healthy lifestyle behaviors through features such as health tracking and personalized reminders. Personalized messaging, tailored to users’ profiles, has been shown to improve engagement and retention in health-related contexts. Prior research has linked personality traits, based on the Big Five model, to preferences for specific app mechanisms, leading to the development of a preference matrix for personalizing mHealth apps. This matrix comprises 15 mechanisms derived from behavior change techniques and gamification elements, intended to guide developers in optimizing engagement according to user profiles.

OBJECTIVE: This study aimed to validate this preference matrix by examining whether the associations between mechanisms and Big Five personality traits reported in the literature align with user preferences observed in an experimental setting.

METHODS: A cross-sectional study was conducted using an online survey that collected demographic data, mHealth app usage, and personality traits. Participants were presented with mockups illustrating 15 mechanisms and were asked to select their preferred options. Logistic regression and ordinal logistic regression analyses were performed to examine associations between personality traits, mechanism selection, and motivation scores. All analyses were adjusted using the Bonferroni correction to account for multiple comparisons.

RESULTS: A total of 214 participants completed the survey (mean age 29.42, SD 10.41 y; n=118, 55.1% women; n=89, 41.6% men; n=5, 2% identifying as other; and n=2, 1% nonrespondents). Higher conscientiousness significantly increased the likelihood of selecting the collection mechanism (eg, collecting badges or points; odds ratio [OR] 1.87, 95% CI 1.27-2.75). For competition (eg, competing with other users), conscientiousness (OR 3.22, 95% CI 1.73-6.00) and agreeableness (OR 1.93, 95% CI 1.08-3.45) were significant predictors. Preferences for rewards (eg, virtual incentives such as points or virtual currency) were associated with conscientiousness (OR 2.36, 95% CI 1.53-3.63) and neuroticism (OR 1.97, 95% CI 1.36-2.86). Additionally, 4 mechanisms-self-monitoring, progression, challenge, and quest-were selected by more than half of the participants, independent of personality traits.

CONCLUSIONS: The findings partially validate the proposed preference matrix. Conscientiousness consistently emerged as a key predictor of preference across multiple mechanisms, highlighting its central role in engagement with gamified mHealth features. While some mechanisms appear to have universal appeal, others show personality-specific preferences, underscoring the value of combining baseline mechanisms with targeted personalization strategies in mHealth app design.

PMID:42018983 | DOI:10.2196/78939

JMIR Res Protoc. 2026 Apr 22;15:e91976. doi: 10.2196/91976.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has a lasting impact on health care utilization, as both the acute infection and post COVID condition (PCC) can lead to increased demand for medical services due to ongoing symptoms.

OBJECTIVE: The aim of this study is to systematically examine health care utilization among individuals after acute SARS-CoV-2 infection in Bavaria, Germany, with a particular focus on PCC. The study combines claims data analysis with qualitative interviews to improve the understanding of objective care pathways and patients’ subjective experiences within the health care system.

METHODS: The research project ‘SOLongCOVID’ employs a mixed-methods design consisting of two subprojects: (1) a retrospective cohort study using claims data from the Bavarian Association of Statutory Health Insurance Physicians (KVB) to analyze care pathways through state sequence analysis, (2) a qualitative study based on semistructured interviews and focus groups with patients with PCC concerning their subjective care experiences. A synthesis process involving a focus group discussion will combine the information from the two subprojects, providing a comprehensive understanding of the care processes of patients with PCC.

RESULTS: The study was funded by the German Federal Joint Committee Innovation Fund in October 2024. Statutory health insurance claims data cover the period from 2019 to 2022, and qualitative interview data collection is planned from May 2025 to August 2026. As of manuscript submission, study preparation and ethics approvals have been completed, and 14 participants have been recruited for the qualitative interviews. Study findings are anticipated to be published from July 2026 to August 2027.

CONCLUSIONS: The results are expected to enhance the understanding of existing barriers and challenges and to support evidence-based recommendations for improving care pathways for patients with specific care needs.

PMID:42018978 | DOI:10.2196/91976

JMIR Res Protoc. 2026 Apr 22;15:e84909. doi: 10.2196/84909.

ABSTRACT

BACKGROUND: Cesarean section (CS) requires perioperative antibiotic prophylaxis (PAP) for the prevention of surgical site infections. However, systemic antibiotics during the peripartum period may induce compositional perturbations of the maternal gut microbiome, a system already characterized by reduced resilience. Data on maternal gut microbiome dynamics after CS with PAP are scarce, largely due to logistical and feasibility barriers that limit the participation of pregnant women and new mothers in conventional clinical studies.

OBJECTIVE: This protocol primarily aims to evaluate the feasibility of a fully decentralized, remote study design for longitudinal gut microbiome research in the peripartum period. Secondary exploratory objectives include the comparative analyses of microbiome composition between CS with PAP and vaginal delivery (VD) without antibiotic exposure to inform future adequately powered studies.

METHODS: The MAMA (Microbiome Changes Due to Antibiotic Prophylaxis in Mothers at Birth) study is a prospective, 2-arm observational cohort study conducted entirely off-site. Women in the third trimester of pregnancy were recruited at 2 German level-1 perinatal centers and affiliated outpatient facilities. Participants underwent either CS with PAP (single dose cefuroxime 1.5 g intravenously) or VD without antibiotics. Stool samples were self-collected at home and returned by mail at 3 predefined time points: late pregnancy (T0), 2 to 3 days post partum (T1), and 90±10 days post partum (T2). Primary outcomes are feasibility indicators, including recruitment rate, sample and questionnaire return rates at each time point, adherence to sampling windows, and participant retention across follow-up. Secondary outcomes are exploratory microbiome measures based on 16S rRNA gene sequencing (V3-V4), including alpha diversity indices, beta diversity metrics, and relative taxonomic abundances. Microbiome analyses are explicitly compositional and hypothesis-generating. Group comparisons and longitudinal within-individual changes will be assessed using nonparametric diversity metrics and multivariate distance-based methods. No confirmatory hypothesis testing is planned.

RESULTS: Recruitment occurred between May 2022 and October 2023, with 37 women enrolled (25 CSs and 12 VDs). Follow-up was completed with receipt of the final stool sample in March 2024. DNA extraction and sequencing were completed in a single batch in October 2024. Bioinformatic processing and statistical analyses were initiated in June 2025 and are ongoing as of December 2025. Results from the exploratory microbiome analyses are expected to be published in 2026.

CONCLUSIONS: This protocol demonstrates the feasibility of conducting fully decentralized, longitudinal microbiome research in a peripartum population without requiring on-site visits. By integrating study procedures into maternal realities, the remote design reduces participation barriers and addresses a clinically relevant research gap that has remained largely unexamined despite routine use of PAP. While microbiome-related outcomes are exploratory, the methodological framework established here provides a scalable model for future maternal and postpartum research, supporting ethically grounded, participant-centered study designs and evidence-informed care strategies.

PMID:42018976 | DOI:10.2196/84909

Neurology. 2026 May 26;106(10):e214989. doi: 10.1212/WNL.0000000000214989. Epub 2026 Apr 22.

ABSTRACT

BACKGROUND AND OBJECTIVES: Implementation of telemedicine expanded options for outpatient neurology care. It remains uncertain which new neurology patients can be appropriately evaluated virtually. We compared subsequent health care utilization after virtual vs in-person new patient neurology visits across 3 academic medical centers.

METHODS: We conducted a retrospective multicenter cohort study of adults with a new outpatient neurology visit from September 2020 through December 2021 using the Vizient Clinical Data Base and Clinical Practice Solutions Center databases. Virtual and in-person patients were matched 1:1 using propensity scores incorporating demographics, clinical characteristics, time period, and previous health care utilization. Outcomes were analyzed overall and stratified by neurologic chief complaint category and institution. We compared rates of subsequent neurologic clinic follow-up, emergency department (ED) visits, and hospitalizations after virtual and in-person encounters. Testing and all-cause ED visits/hospitalizations were also assessed.

RESULTS: We identified 10,428 virtual and 36,767 in-person neurology new outpatient visits. After propensity score matching, 8,202 virtual visits were matched to 8,202 in-person visits. Neurology follow-up within 90 days did not differ between virtual and in-person visits (24.6% vs 23.7%, p = 0.18). Thirty-day neurology clinic follow-up was slightly lower after virtual visits, whereas follow-up at 6 months and 1 year was similar between groups. Neurologic ED visits and hospitalizations within 90 days were similar (0.9% vs 0.8%, p = 0.23 and 1.8% vs 1.7%, p = 0.47, respectively). All-cause ED visits and hospitalizations within 90 days were also comparable (1.8% vs 1.7%, p = 0.59 and 2.2% vs 1.8%, p = 0.13, respectively). Analyses by chief complaint found that 90-day follow-up was higher after in-person visits for dementia, whereas 30- and 90-day follow-up was higher after virtual visits for Parkinson disease and multiple sclerosis, and 90-day follow-up was higher after virtual visits for headache. Testing was more frequent after in-person visits for certain chief complaints.

DISCUSSION: In this propensity score-matched multicenter cohort, new neurology patients seen virtually had similar downstream utilization as those seen in-person, including comparable 90-day follow-up and similar neurologic and all-cause ED visits and hospitalizations. Although follow-up varied modestly by chief complaint and testing was more frequent after some in-person visits, no major differences emerged overall.

PMID:42018961 | DOI:10.1212/WNL.0000000000214989

Am J Public Health. 2026 May;116(S2):S75-S78. doi: 10.2105/AJPH.2026.308423.

ABSTRACT

Findings from a 2021 Special Olympics International study indicated that 69% of health care professionals reported having little to no training caring for people with intellectual and developmental disabilities. This gap in education can lead to wide disparities in care delivery. Special Olympics International developed an interprofessional curriculum to educate health care students and professionals globally. To date, 130 schools have implemented this training for health profession students with statistically significant self-reported improvements in knowledge and communication confidence. (Am J Public Health. 2026; 116(S2):S75-S78. https://doi.org/10.2105/AJPH.2026.308423).

PMID:42018949 | DOI:10.2105/AJPH.2026.308423

Am J Public Health. 2026 May;116(S2):S70-S74. doi: 10.2105/AJPH.2026.308503.

ABSTRACT

Individuals with intellectual and developmental disabilities (IDD) face significant barriers to health care access. Special Olympics Healthy Athletes addresses this through health screenings and care coordination. From 2023 to 2025, 580 individuals received multidisciplinary referral support. Coordinators provided no-cost benefits navigation, transportation, and provider connections. Common barriers included difficulty locating in-network providers, financial constraints, and limited insurance coverage for specialty services. This highlights the impact of dedicated referral coordination in overcoming systemic barriers and improving care access for individuals with IDD. (Am J Public Health. 2026; 116(S2):S70-S74. https://doi.org/10.2105/AJPH.2026.308503).

PMID:42018944 | DOI:10.2105/AJPH.2026.308503

J Am Acad Orthop Surg Glob Res Rev. 2026 Apr 22;10(4). doi: 10.5435/JAAOSGlobal-D-26-00056. eCollection 2026 Apr 1.

ABSTRACT

INTRODUCTION: Patient insurance type influences treatment timelines in meniscal injuries. This study assessed differences in time to presentation, time to treatment, and clinical outcomes of meniscal injuries in young patients with Medicaid versus commercial insurance. It was hypothesized that patients with Medicaid would have greater delays in time to presentation and treatment and inferior clinical outcomes.

METHODS: This retrospective cohort investigation included patients ages 21 years and younger who underwent meniscal repair by a single sports medicine surgeon. Demographics, injury specifications, and treatment timelines were analyzed. Preoperative, 3-, 6-, and 12-month postoperative pain, International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were compared.

RESULTS: Time to presentation (163 vs 62 days, P = 0.008) and time from injury to surgery (228 vs 111 days, P = 0.006) were markedly increased in the Medicaid group. Pain (0.5 vs 0.3, P = 0.803), IKDC (89.3 vs 93.1, P = 0.060), Lysholm (94.9 vs 95.1, P = 0.576), and Tegner (7.3 vs 7.3, P = 0.977) scores of Medicaid vs commercial patients were similar at 12 months postoperative. Tegner score of the Medicaid group at 12 months postoperative (7.3) was markedly lower than the preinjury average (8.2) (P = 0.024). The 12-month postoperative IKDC score of Medicaid vs commercial patients with ACL and meniscus tears were markedly different (91.8 vs 97.4, P = 0.044).

CONCLUSION: Young patients with Medicaid insurance undergo meniscal repair nearly 3 months later than those with commercial insurance, return to preinjury activity levels less frequently, and have lower 12-month IKDC scores with combined ACL and meniscus injury. Once established with an orthopaedic surgeon, patients have similar timelines for surgery. The discrepancy in time from injury to surgery is an inequality that deserves to be addressed.

PMID:42018934 | DOI:10.5435/JAAOSGlobal-D-26-00056

Neurol Res. 2026 Apr 22:1-36. doi: 10.1080/01616412.2026.2661743. Online ahead of print.

ABSTRACT

OBJECTIVES: Schizophrenia is a neuropsychiatric disorder that affects emotional, behavioral, and brain functions that can be tracked using electroencephalography (EEG). This research conducts a comparative evaluation of deep learning models utilizing EEG time-frequency and spectral analysis methods to automate schizophrenia detection.

METHODS: Two compatible EEG datasets were merged, yielding a total of 934 EEG samples from 237 subjects (121 schizophrenia patients and 116 controls). Independent Component Analysis (ICA) was applied for signal decomposition. By deriving time-frequency representations using Continuous Wavelet Transform (CWT) and Fast Fourier Transform (FFT), scalogram and spectral inputs for deep learning models were obtained. Six architectures, including CNN variants, CNN-FFT, CNN-ELM, CNN-LSTM, ResNet Transfer, and a Transformer-based model, were evaluated with data augmentation and class balancing to improve robustness.

RESULTS: While variations in numerical performance were observed across models, statistical analysis indicated that these differences were not significant.

DISCUSSION: The study presents results that underscore the benefits of combining time-frequency analysis with deep learning for EEG-based schizophrenia diagnosis, especially via spectral feature extraction in CNN architectures. Furthermore, it provides insights consistent with known neurophysiological patterns in schizophrenia, emphasizing the significance of model interpretability for clinical translation. Future research will focus on the integration of multimodal neuroimaging and the enhancement of explainability frameworks to augment diagnostic reliability.

PMID:42018932 | DOI:10.1080/01616412.2026.2661743

J Am Acad Orthop Surg Glob Res Rev. 2026 Apr 22;10(4). doi: 10.5435/JAAOSGlobal-D-25-00238. eCollection 2026 Apr 1.

ABSTRACT

INTRODUCTION: Sociodemographic differences markedly affect postoperative outcomes in lumbar fusion surgery, often leading to higher infection rates, readmissions, emergency department (ED) visits, and prolonged hospital stays. This study examines the associations between sociodemographic factors and clinical outcomes after elective lumbar fusion surgery.

METHODS: We retrospectively analyzed medical records of patients aged ≥18 years who underwent lumbar or lumbosacral fusion for degenerative conditions from 2018 to 2022 at a single academic institution. ED returns and readmissions within 3 months were also recorded. Statistical analysis was conducted using chi-square tests, t-tests, ANOVA, and multivariate logistic regression models.

RESULTS: A total of 484 patients (54.1% male) were included. Most patients were White (80.4%) and non-Hispanic (91.5%). Men exhibited lower ED utilization (16% versus 23%) and readmission (11.5% versus 19.8%) rates than women. Men were more frequently discharged home (87%) compared with women (79.3%), with fewer discharges to skilled nursing or rehab facilities. No significant differences in length of stay, readmission, ED return, or discharge disposition were observed across racial groups. The private insurance group had shorter hospital stays (3.1 ± 1.7 days) than Medicare/Medicaid patients (3.8 ± 2.6 days) and other groups (4.7 ± 3.3 days, P = 0.005). Medicare/Medicaid patients had higher ED return and readmission rates and were less likely to be discharged home (P < 0.001). Multivariate models revealed that sex and payer status significantly affected readmissions and discharge dispositions.

CONCLUSION: Women and Medicare/Medicaid patients experience poorer postoperative outcomes, with increased ED visits and readmissions after lumbar fusion surgery. Race did not significantly affect outcomes, although small sample sizes may have limited this analysis.

PMID:42018931 | DOI:10.5435/JAAOSGlobal-D-25-00238

An Acad Bras Cienc. 2026 Apr 20;98(1):e20240983. doi: 10.1590/0001-3765202620240983. eCollection 2026.

ABSTRACT

The COVID-19 pandemic’s enforced social isolation significantly disrupted numerous economic activities, notably road transport. This period, dubbed “anthropause,” provided a unique moment to study its effects on wildlife, specifically mammal roadkill patterns on Brazil’s BR-101/North-RJ highway. This research assessed whether reduced vehicle traffic during the pandemic’s first year impacted mammal roadkill rates. Monitoring was conducted monthly from March 2019 to February 2021, spanning pre-pandemic and pandemic periods, across four 10-km highway sections. Findings indicated a 45% decrease in mammal roadkills during the pandemic, especially in the third quadrimester (November-2020 to February-2021) of the pandemic period (W = 77; p = 0.027). Of the nine taxa examined, Didelphis aurita and Coendou spinosus experienced the most significant reductions in roadkill rate. No link was found between climatic conditions and roadkill frequency, yet a noteworthy correlation emerged between vehicle traffic volume and roadkill rates (r = 0.281; p = 0.005). Despite a temporary decline in traffic, varying roadkill rates across highway segments pointed to diverse responses from environmental and traffic variations. The study emphasizes that even modest reductions in traffic can significantly lower roadkill rates, supporting the idea that the anthropause positively influenced the reduction of road-induced mortality among Neotropical mammals.

PMID:42018921 | DOI:10.1590/0001-3765202620240983