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Nevin Manimala Statistics

VR-based psychotherapy intervention on alleviating depression and anxiety for Hong Kong populations: a mixed method pilot implementation study

Int Rev Psychiatry. 2026 Feb 16:1-9. doi: 10.1080/09540261.2026.2631758. Online ahead of print.

ABSTRACT

The increasing prevalence of common mental disorders such as depression and anxiety found in Hong Kong, coupled with substantial public healthcare service gaps, necessitates accessible and immediate therapeutic interventions. This pilot implementation study investigated the feasibility, safety and acceptability of a culturally and linguistically adapted Virtual Reality (VR)-based psychotherapy intervention for Cantonese-speaking adults experiencing mild-to-moderate depression and anxiety in Hong Kong. Employing a sequential explanatory mixed-methods design, the study utilized four culturally specific VR scenarios, namely “Crying Girl” (targeting depression/self-compassion), “MTR” (enabling social anxiety exposure), “Emigration” (addressing separation-related anxiety), and “Rock-paper-scissors” (enhancing prosocial functioning). Quantitative pre-post assessments were combined with qualitative semi-structured interviews and focus groups to explore user experience, immersion, and perceived therapeutic mechanisms. Preliminary quantitative findings indicated statistically significant reductions in depressive symptoms and increases in self-compassion in the “Crying Girl” scenario, alongside reductions in stress in the “MTR” scenario. Focus groups and interviews revealed that participants highly valued immersion, ecological validity, and culturally resonant scenarios in therapeutic practice. Barriers such as technical imperfections, device complexity, and interface demands were identified, particularly for users with limited digital experience. This pilot study highlights the premise of culturally adapted VR psychotherapy as a safe and engaging intervention, emphasizing the need for user-centred design iterations to improve accessibility and subsequent larger controlled trials to rigorously evaluate efficacy and inform real-world implementation.

PMID:41693503 | DOI:10.1080/09540261.2026.2631758

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Longitudinal changes in vibration-controlled transient elastography in pediatric fatty liver disease

J Pediatr Gastroenterol Nutr. 2026 Feb 16. doi: 10.1002/jpn3.70380. Online ahead of print.

ABSTRACT

OBJECTIVES: There is a lack of research describing changes in vibration-controlled transient elastography (VCTE) parameters in pediatric metabolic dysfunction-associated steatotic liver disease (MASLD). We hypothesized that VCTE measurements would be positively associated with changes in anthropomorphic and biochemical parameters in pediatric MASLD over time, making VCTE a useful tool to monitor MASLD in children.

METHODS: This was a retrospective chart review of children under 18 with MASLD evaluated at Boston Children’s Hospital from 2015 to 2023. Demographic, biochemical, and anthropometric data were collected.

RESULTS: The cohort consisted of 336 children (72.8% male), 192 of which were less than 18 and had two or more VCTE exams, with median age 12.0 (interquartile range [IQR] 10.0-14.0) years. The mean time between VCTE exams was 16.8 months (standard deviation [SD] 11.1). Based on a linear mixed effects model, a unit increase in body mass index (BMI) z-score was associated with a 1.02 kPa increase in liver stiffness measurement (LSM) (p = 0.012). Follow-up time was statistically significantly associated with increasing liver stiffness (p = 0.015) after controlling for baseline age and BMI z-score. For controlled attenuation parameter (CAP), the linear mixed effects model demonstrated a unit increase in BMI z-score was associated with an 88.22 dB/m increase (p < 0.001).

CONCLUSIONS: This is the first study to describe changes in VCTE parameters over time in children with MASLD. Changes in BMI were positively associated with changes in LSM and CAP. VCTE can be an effective tool to monitor changes in disease status over time in pediatric MASLD.

PMID:41693480 | DOI:10.1002/jpn3.70380

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Effect of Exercise-Based Interventions on HbA1c in Adults with Type 1 Diabetes: A Systematic Review and Meta-Analysis

Cell J. 2026 Jan 31;27(1):1-14. doi: 10.22074/cellj.2025.2050534.1775.

ABSTRACT

OBJECTIVE: This study intends to determine whether exercise-based interventions improve haemoglobin A1c (HbA1c) levels in adults with type 1 diabetes (T1D) and examines how different types of exercise influence this association.

MATERIALS AND METHODS: A search of the appropriate electronic databases revealed 18 eligible studies from initial 685 records. The effect of exercise training on HbA1c was examined in two parts: i. Exercise training intervention compared to a T1D control group (between-group analysis) and ii. Pre/post comparison of exercise training intervention on T1D patients (within-group analysis).

RESULTS: The between-group results showed that exercise training had a statistically significant reduction in HbA1c [mean difference (MD), confidence interval (CI)]: -0.39 (-0.64, -0.15), P=0.002, I2=0%). Subgroup analysis based on the types of exercise training showed a statistically significant effect of high-intensity interval training (HIIT) on HbA1c levels in both the within-group analyses [MD: -0.24 (-0.45, -0.02), P=0.03, I2=0%] and between-group analyses [MD: -0.39 (-0.64, -0.15), P=0.002, I2=0%].

CONCLUSION: The meta-analysis and meta-regression results suggest that HIIT may be a supportive intervention in T1D patients; however, there was insufficient evidence to confirm these findings. Data from more randomised controlled trials (RCTs) are needed to compare the effect of different types of exercise on HbA1c levels in T1D patients [registration: PROSPERO (CRD42023414580)].

PMID:41693438 | DOI:10.22074/cellj.2025.2050534.1775

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Accessible decision-making capacity evaluations for patients with aphasia: a quality improvement project to develop, implement, and evaluate an online training module for interdisciplinary healthcare providers

Disabil Rehabil. 2026 Feb 16:1-12. doi: 10.1080/09638288.2026.2629823. Online ahead of print.

ABSTRACT

PURPOSE: Decision-making capacity (DMC) is the ability to make informed, autonomous choices. In healthcare settings, a range of providers typically evaluate DMC using a semi-structured interview approach. The presence of aphasia introduces a significant challenge to DMC assessments because a patient’s communication challenges can mask their underlying capacity. This quality improvement project aimed to (1) train providers to integrate evidence-based communication accommodations with support from a speech-language pathologist (SLP) to reduce the risk of underestimating capacity during a DMC assessment; and (2) assess the effectiveness of the training intervention.

MATERIALS AND METHODS: A team of SLPs and bioethicists in a research and rehabilitation hospital developed and evaluated an online training module for DMC assessors and SLPs to support the delivery of accessible DMC evaluations for patients with aphasia. Trainees completed pre- and post-training surveys to indicate self-reported change in knowledge and confidence and provide feedback on their learning experience.

RESULTS: The training resulted in positive learning experiences and statistically significant increases in self-reported knowledge and confidence for DMC evaluators and SLPs in providing accessible DMC evaluations for individuals with aphasia.

CONCLUSION: The online training module was viewed as effective in promoting communication accessible DMC evaluations by interdisciplinary provider trainees.

PMID:41693432 | DOI:10.1080/09638288.2026.2629823

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A Critical Appraisal of Nephrometry in Robot-Assisted Partial Nephrectomy: Why the RPN Score Outperforms R.E.N.A.L. and PADUA in the Robotic Era

J Endourol. 2026 Feb 16:8927790261422977. doi: 10.1177/08927790261422977. Online ahead of print.

ABSTRACT

OBJECTIVE: To critically appraise the Radius, Exophytic/endophytic, Nearness of tumor to collecting system or sinus, Anterior/posterior, Location relative to polar lines (R.E.N.A.L.), Preoperative Aspects and Dimensions Used for an Anatomical classification (PADUA), and Radius, Position, iNvasion of sinus (RPN) nephrometry systems with respect to their classification of tumor complexity for surgical planning in robot-assisted partial nephrectomy (RAPN) and to compare their statistical validity, methodological rigor, and predictive performance.

MATERIALS AND METHODS: A structured synthesis of published evidence identified large multicenter series, prospective cohorts, and meta-analyses from 2009 to 2025 that evaluated the predictive accuracy, methodological design, and clinical relevance of these systems. Key evaluation domains included statistical validation, anatomical parameter selection, and correlation with surgeon-perceived difficulty in RAPN.

RESULTS: Both the R.E.N.A.L. and PADUA scores were developed using empirically selected parameters and have historically been validated based on their correlation with perioperative outcomes. However, evidence in the literature now shows that such correlations are inconsistent and often clinically irrelevant in RAPN. In contrast, the RPN score was developed using a statistically modeled approach, reflecting the real-world surgical difficulty of RAPN as perceived by experienced robotic surgeons.

CONCLUSION: Current evidence does not support the continued use of R.E.N.A.L. and PADUA scores as validated tools in RAPN. The RPN score, with its statistically validated, anatomy-based methodology and alignment with surgical difficulty, represents a scientifically superior and clinically practical alternative for standardizing tumor complexity in RAPN.

PMID:41693428 | DOI:10.1177/08927790261422977

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Construct Validity of the WAIS- 5: Complementary Exploratory and Confirmatory Factor Analyses of the 20 Primary and Secondary Subtests

Assessment. 2026 Feb 16:10731911251412219. doi: 10.1177/10731911251412219. Online ahead of print.

ABSTRACT

The Wechsler Adult Intelligence Scale-Fifth Edition (WAIS-5) latent factor structure was assessed using complementary hierarchical exploratory factor analyses (EFA) with the Schmid and Leiman procedure and confirmatory factor analyses (CFA) using the standardization sample (N = 2,020) correlation matrix and descriptive statistics of the 20 primary and secondary WAIS-5 subtests. The WAIS-5 Technical and Interpretive Manual did not include EFA, CFA with fewer than five first-order (group) factors, CFA with rival bifactor models, or model-based reliability and dimensionality estimates; thus, the present independent structural validity assessment corrects this evidential lacuna to help guide ethical and evidence-based interpretation. EFA results did not support five latent factors with separate Visual Spatial and Fluid Reasoning factors. Instead, a four-factor model with Visual Spatial and Fluid Reasoning factors merged into the former Perceptual Reasoning factor and measurement dominated by a general intelligence (g) factor-similar to the WAIS-IV structure-was supported. CFA results indicated that a bifactor model with four group factors provided the best fit, consistent with the EFA findings. Overall, the EFA and CFA results did not support the purported WAIS-5 structure and instead replicated findings from independent assessments of the WISC-V with standardization and clinical samples, that indicated primary, if not exclusive, interpretation of the FSIQ as an estimate of psychometric g.

PMID:41693426 | DOI:10.1177/10731911251412219

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Physical Activity and Sport Interventions to Prevent Drug Use: A Systematic Review Including Different Intervention Paradigms

Subst Use Misuse. 2026 Feb 16:1-19. doi: 10.1080/10826084.2026.2628149. Online ahead of print.

ABSTRACT

Background: Sport and physical activity are increasingly used in adolescent substance use prevention, but interventions differ substantially in how sport is integrated. This systematic review examined preventive effects according to physical activity implementation paradigm. Methods: Five databases and prior reviews were searched. Interventions were classified into three paradigms: Preventive Sport (PS), where sport alone is expected to prevent use; Prevention Combined with Sport (PCS), where sport and prevention are delivered in parallel; and Prevention Through Sport (PTS), where preventive strategies are embedded within the sport context. A structured narrative synthesis was conducted of substance use, intentions, and risk and protective factors. Results: Nineteen interventions (25 studies) met inclusion criteria. PS interventions showed little evidence of preventive effects. PCS and PTS interventions reported preventive effects across several outcomes, particularly for alcohol and tobacco. PCS effects appeared more consistent in the short term, whereas PTS showed more sustained effects across substances and follow-up periods. Effect sizes were generally small and heterogeneity across formats, mechanisms, and outcomes was substantial. Conclusions: The paradigms differ in sport use, the preventive mechanisms they activate, and outcomes. Sport alone (PS) shows insufficient evidence for recommendation, whereas combined (PCS) and through-sport (PTS) approaches show more promising patterns. This research contributes to a better understanding of the role of sport in prevention, helping professionals and decision-makers to design more effective interventions and make better decisions.

PMID:41693421 | DOI:10.1080/10826084.2026.2628149

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Association of Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels With Acute Kidney Injury and Postpartum Renal Functional Recovery in Patients With Preeclampsia

J Obstet Gynaecol Res. 2026 Feb;52(2):e70204. doi: 10.1111/jog.70204.

ABSTRACT

OBJECTIVE: To examine the association between neutrophil gelatinase-associated lipocalin (NGAL) level and acute kidney injury as well as postpartum renal functional recovery.

METHODS: A retrospective study was conducted on 100 preeclampsia patients who were admitted and delivered in the Department of Obstetrics at our hospital between July 2024 and January 2025. Among them, 26 patients had concurrent acute kidney injury (AKI) while 74 did not. Demographic data and laboratory parameters were collected for all patients. Statistical analyses included Student’s t-test, Pearson correlation analysis, and receiver operating characteristic (ROC) curve analysis for comparisons.

RESULTS: Compared with the non-AKI group, the AKI group exhibited significantly higher levels of 24-h urinary protein excretion (1.91 ± 0.68 vs. 0.74 ± 0.20 g/24 h, p < 0.001), D-dimer (5.15 ± 0.73 vs. 3.15 ± 1.13 mg/L, p < 0.001), and neutrophil gelatinase-associated lipocalin (NGAL; 461.33 ± 75.74 vs. 370.22 ± 56.51 ng/mL, p < 0.001), but a significantly lower estimated glomerular filtration rate (eGFR; 165.27 ± 19.44 vs. 181.66 ± 25.80 mL/min/1.73m2, p = 0.004). NGAL level showed positive correlations with D-dimer (r = 0.402) and 24-h urinary protein excretion (r = 0.367). The area under the curve (AUC) for predicting AKI occurrence superimposed on preeclampsia (PE) was 0.974 for 24-h urinary protein excretion,0.699 for eGFR,0.923 for D-dimer and 0.841 for NGAL, indicating their predictive value. Compared with Day 1, NGAL levels decreased on Days 5 and 7 in the renal function recovery group, while NGAL levels increased on Day 7 in the group without renal function recovery.

CONCLUSION: Elevated serum NGAL levels at admission are significantly associated with acute kidney injury in patients with preeclampsia and serve as a valuable predictor for its occurrence, as evidenced by a high AUC.

PMID:41693384 | DOI:10.1111/jog.70204

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The Correlation of Ethical Climate With Work Engagement Among Jordanian Nurses in the Emergency Department: A Cross-Sectional Study

Int Nurs Rev. 2026 Mar;73(1):e70155. doi: 10.1111/inr.70155.

ABSTRACT

AIM: This study aimed to investigate work engagement and its association with ethical climate among Jordanian nurses in the emergency department.

BACKGROUND: Work engagement and ethical climate are critical factors for emergency nurses who work in high-pressure environments that require rapid clinical and ethical decision-making.

METHODS: A cross-sectional study was conducted. Data were collected from a sample of 650 emergency nurses in Jordan from March to May 2025. Measures comprised the Ethical Climate Questionnaire (ECQ), the Utrecht Work Engagement Scale 9 (UWES-9), and sociodemographic variables. A hierarchical multiple regression analysis was used to analyze the data.

RESULTS: The participants reported moderate levels of both satisfaction with the ethical climate and work engagement. A positive correlation existed between ethical climate and work engagement. Higher levels of work engagement correlated with participants who were female, single, divorced or widowed, employed in the private sector, and had lower monthly income. Five models resulted from the hierarchical multiple regression. They indicated that ethical climate, monthly income, marital status, and gender accounted for a meaningful proportion of variance in work engagement in this sample. Ethical climate was the strongest factor associated with work engagement.

CONCLUSION: Enhancing the ethical climate within emergency departments could be an effective strategy for strengthening nurses’ work engagement and sustaining workforce performance.

IMPLICATIONS FOR NURSING: Nursing managers should promote ethical dialogue, supportive supervision, continuous training, and equitable workplace practices to strengthen work engagement among emergency nurses.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: Healthcare policymakers should support ethical workplace policies, inclusive leadership development, and organizational empowerment to enhance an ethical climate in emergency departments.

PMID:41693374 | DOI:10.1111/inr.70155

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Automated Ergonomic Assessment in Repetitive Culinary Tasks

IISE Trans Occup Ergon Hum Factors. 2026 Feb 15:1-17. doi: 10.1080/24725838.2026.2615463. Online ahead of print.

ABSTRACT

OCCUPATIONAL APPLICATIONSThis study introduces an automated ergonomic assessment system tailored for repetitive culinary tasks. By combining joint tracking with the Assessment of Repetitive Tasks (ART) tool, the system identifies movement patterns and evaluates ergonomic risks. Results show strong alignment with expert evaluations. Operating with standard video input, the system minimizes the need for manual observation, enabling consistent and scalable risk evaluations. Designed for practical use, the system can be deployed in commercial kitchens using affordable cameras and minimal setup. The output aligns with ART categories, helping safety managers pinpoint high-risk tasks. These findings can inform ergonomic interventions, such as tool redesign or task rotation. User-friendly and requiring minimal training, the system is well-suited for small to medium-sized food operations. It facilitates early detection of musculoskeletal risks and complements existing safety protocols. With further development, the system holds potential for broader applications in fields like healthcare or manufacturing.

PMID:41693346 | DOI:10.1080/24725838.2026.2615463