Tag: nevin manimala

J Psychosoc Nurs Ment Health Serv. 2026 Apr 28:1-13. doi: 10.3928/02793695-20260414-01. Online ahead of print.

ABSTRACT

PURPOSE: To compare relational authenticity and empathy among rural and urban psychiatric-mental health nurses and examine their correlation with recovery capital in individuals with substance use disorder (SUD) using Peplau’s Theory of Interpersonal Relations as a conceptual framework.

METHOD: Using a descriptive comparative study design, 278 participants were recruited from rural and urban psychiatric settings. Nurses (n = 152) completed the Kernis-Goldman Authenticity Inventory, Interpersonal Reactivity Index, and Working Alliance Inventory-Short Version. Patients (n = 126) with SUD were evaluated using the Brief Assessment of Recovery Capital.

RESULTS: A statistically significant difference was observed in responses regarding the relational orientation domain of authenticity, as well as the fantasy and empathic concern dimensions of empathy (p = .013, p = .042, and p = .022, respectively). Empathy and therapeutic alliance were identified as significant independent predictors of authenticity among nurses. Higher levels of empathy and authentic engagement were positively associated with increased recovery capital in patients with SUD.

CONCLUSION: Empathetic and authentic nurse-patient relationships, as framed by Peplau’s theory, are critical to supporting recovery in individuals with SUD. Enhancing these relational competencies, especially in under-resourced rural settings, may improve mental health outcomes and reduce disparities in recovery support.

PMID:42030478 | DOI:10.3928/02793695-20260414-01

Vet Med Sci. 2026 May;12(3):e70962. doi: 10.1002/vms3.70962.

ABSTRACT

OBJECTIVE: This study aimed to investigate the potential systemic gastrointestinal (GI) effects of short-term topical administration of ocular steroids and non-steroidal anti-inflammatory drugs (NSAIDs) in rats.

ANIMALS: A total of 56 adult male Wistar rats were assigned to seven treatment groups (n = 8 for each group), receiving topical applications of saline, prednisolone acetate, dexamethasone phosphate, loteprednol etabonate, ketorolac tromethamine, nepafenac or diclofenac sodium for 1 week.

METHODS: GI bleeding was assessed using faecal occult blood tests, gastric and duodenal tissues were analysed histopathologically, and endoscopic evaluations were performed.

RESULTS: Positive faecal occult blood results were observed in the prednisolone acetate group (3/8; 37.5%), dexamethasone phosphate (2/8; 25%), diclofenac sodium (1/8; 12.5%) and loteprednol etabonate (1/8; 12.5%). No positive results were recorded in the ketorolac tromethamine, nepafenac, or saline groups (0%). Differences between groups were not statistically significant (p > 0.05). No significant within-group differences between baseline and post-treatment results were detected (p > 0.05). Endoscopic scores ranged from 0 to 1 across all groups, and histopathology revealed no abnormalities.

CONCLUSIONS AND CLINICAL RELEVANCE: Short-term topical ocular steroid and NSAID treatments were not associated with statistically significant systemic gastrointestinal alterations under the conditions of this study.

PMID:42030432 | DOI:10.1002/vms3.70962

J Chem Theory Comput. 2026 Apr 24. doi: 10.1021/acs.jctc.6c00293. Online ahead of print.

ABSTRACT

Nuclear quantum effects (e.g., zero-point motion and tunneling) can control hydrogen transfer and diffusion, but fully quantum dynamics is rarely feasible for realistic systems. Ring-polymer molecular dynamics (RPMD) samples quantum statistics with a classical ring polymer, yet ab initio RPMD is costly because electronic-structure energies and forces are required for every bead at every time step. Here, we introduce a Feynman path tube-guided surrogate RPMD framework that propagates all beads on an on-the-fly surrogate ring-polymer Hamiltonian with an uncertainty estimate: ab initio data are acquired only when the uncertainty exceeds a threshold and are shared across beads and trajectories. Combined with well-tempered metadynamics, the method targets quantum free-energy surfaces and activation barriers. On gas-phase OH + H₂O and CH₄ + Cl benchmarks with full-dimensional reference potentials, surrogate ab initio RPMD reproduces brute-force RPMD profiles within 0.1-0.2 kcal/mol, preserves the symmetry of the OH + H₂O identity exchange, and resolves subkcal barriers. We then compute ab initio RPMD free-energy surfaces for proton transfer on TiO₂(011), H migration on graphene, and H₂ dissociative chemisorption on Cu(111), including a two-dimensional surface and minimum free-energy path on the metal. Across all five systems, the number of ab initio calls grows sublinearly with bead number, delivering speedups of 10³-10⁵ ring-polymer bead-steps per QM evaluation and reducing the expensive force workload by three to more than 4 orders of magnitude. Tube-aware surrogate sharing therefore makes quantum-statistical free-energy sampling with ab initio RPMD practical for both molecular and interfacial reactions.

PMID:42030428 | DOI:10.1021/acs.jctc.6c00293

PLoS Med. 2026 Apr 24;23(4):e1005081. doi: 10.1371/journal.pmed.1005081. Online ahead of print.

ABSTRACT

Why obesity increases cancer risk has long remained a biological mystery. Rapid advances in statistical and analytical methods are now opening the door to mechanistic discoveries that may finally help resolve this question.

PMID:42030412 | DOI:10.1371/journal.pmed.1005081

PLoS One. 2026 Apr 24;21(4):e0345413. doi: 10.1371/journal.pone.0345413. eCollection 2026.

ABSTRACT

Engaging the private sector in contraceptive method supply is critical for creating equitable, sustainable, and accessible healthcare systems. To achieve this, it is essential to understand where women obtain their modern contraceptives. While national-level estimates provide valuable insights into overall trends in contraceptive supply, they often obscure variation within and across subnational regions. Addressing localised needs has become increasingly important as countries adopt decentralised models for family planning services. Decentralization has also underscored the need for reliable subnational estimates of key family planning indicators. The absence of regularly collected subnational data has hindered effective monitoring and decision-making. To bridge this gap, we propose a novel approach that leverages latent attributes in Demographic and Health Survey (DHS) data to produce Bayesian probabilistic projections of contraceptive method supply shares (the proportions of modern contraceptive methods supplied by public and private sectors) with limited data. Our modelling framework is built on Bayesian hierarchical models. Using penalized splines to track public and private supply shares over time, we leverage the spatial nature of the data and incorporate a correlation structure between recent supply share observations at national and subnational levels. This framework contributes to the domain of subnational estimation of proportions in data-sparse settings, outperforming comparable and previous approaches. As decentralization continues to reshape family planning services, producing reliable subnational estimates of key indicators is increasingly vital for researchers and policymakers.

PMID:42030401 | DOI:10.1371/journal.pone.0345413

PLoS One. 2026 Apr 24;21(4):e0347849. doi: 10.1371/journal.pone.0347849. eCollection 2026.

ABSTRACT

BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation technique that activates vagal afferents projecting to prefrontal-limbic circuits implicated in attention, memory, and emotion regulation. Preliminary studies suggest that taVNS may enhance cognitive performance; however, the evidence remains fragmented across domains and populations.

OBJECTIVES: This systematic review and meta-analysis aim to (1) quantify the overall effects of taVNS on cognitive functions, (2) examine its efficacy across clinical and non-clinical populations, and (3) identify moderators influencing variability in outcomes, including stimulation parameters, participant characteristics, and study design features.

METHODS: Following PRISMA-P guidelines, this protocol will be prospectively registered with PROSPERO. Six databases (PubMed, EMBASE, PsycINFO, Web of Science, CENTRAL, and Scopus) and major trial registries will be systematically searched. Eligible studies include randomised controlled trials assessing validated cognitive outcomes following taVNS compared with sham or active controls. Effect sizes will be calculated as Hedges’ g and pooled using random-effects models. Heterogeneity will be evaluated with I² and τ statistics; moderator and meta-regression analyses will explore dose-response and population effects. Risk of bias will be assessed with RoB 2 for randomised trials and ROBINS-I for non-randomised studies, and the certainty of evidence will be rated using GRADE separately by study design.

EXPECTED RESULTS AND CONCLUSIONS: This review will provide the first quantitative meta-analytic synthesis of taVNS-induced cognitive modulation across executive, attentional, affective, and learning domains in both clinical and healthy populations, complementing recent narrative syntheses by offering pooled effect size estimates, formal heterogeneity assessment, and a GRADE-rated evidence hierarchy. By delineating domain-specific efficacy and optimal stimulation parameters, the findings aim to inform future clinical applications and the development of standardized neuromodulation protocols.

PMID:42030358 | DOI:10.1371/journal.pone.0347849

J Clin Pharmacol. 2026 Apr;66(4):e70192. doi: 10.1002/jcph.70192.

ABSTRACT

Labetalol is widely prescribed as a first-line antihypertensive in pregnancy; however, rare but potentially severe idiosyncratic hepatotoxicity has been reported, with a disproportionately strong reporting signal for liver injury relative to other β-blockers. In this report, a fatal case is described in which mild initial symptoms rapidly progressed to fulminant hepatocellular injury and acute liver failure within days, underscoring the importance of early recognition of drug-induced liver injury and prompt discontinuation of labetalol. A PRISMA-guided systematic review of MEDLINE, Embase, CINAHL, Cochrane Library, PubMed, and Google Scholar (from inception to December 2025) identified 27 published case reports. Patients were predominantly female (≈80%), and one-third were pregnant or postpartum. Latency ranged from 7 to 365 days (median ≈60 days). The injury phenotype was consistently hepatocellular, often with autoimmune-like serologic or histologic features. Outcomes included full recovery in most (≈75%), but also liver transplantation and death. In the FDA Adverse Event Reporting System (2020Q1-2025Q1), labetalol showed strong disproportionality signals for DILI (PRR 22.7, 95% CI 15.6-33.1; ROR 23.7, 95% CI 16.0-35.1; IC025 2.5) and autoimmune hepatitis (PRR 59.8, 95% CI 34.1-104.8; ROR 60.9, 95% CI 34.4-108.1; IC025 2.8), which persisted when restricted to other β-blockers as comparators. Signals for acute hepatic failure and hyperbilirubinemia were elevated but less statistically robust. The available evidence is consistent with a clinically meaningful and biologically plausible association between labetalol and idiosyncratic hepatotoxicity, supporting heightened clinical awareness and further mechanistic and population-based study.

PMID:42030085 | DOI:10.1002/jcph.70192

Chaos. 2026 Apr 1;36(4):043133. doi: 10.1063/5.0324747.

ABSTRACT

The renewal process is a key statistical model for describing a wide range of stochastic systems in physics. This work investigates the behavior of the probability distribution of the number of renewals in renewal processes at the short time limit, with a focus on cases where the number of renewals is large. We find that the specific details of the sojourn time distribution ϕ(τ) in this limit can significantly modify the behavior in the large-number-of-renewals regime. We explore both ordinary and equilibrium renewal processes, deriving results for various forms of ϕ(τ). Using saddle-point approximations, we analyze cases where ϕ(τ) follows a power-series expansion, includes a cutoff, or exhibits non-analytic behavior near τ=0. Additionally, we show how the short-time properties of ϕ(τ) shape the decay of the number of renewals in equilibrium compared to ordinary renewal processes. The probability of the number of renewals plays a crucial role in determining rare event behaviors, such as Laplace tails. The results obtained here are expected to help advance the development of a theoretical framework for rare events in transport processes in complex systems.

PMID:42030067 | DOI:10.1063/5.0324747

Chaos. 2026 Apr 1;36(4):043134. doi: 10.1063/5.0323615.

ABSTRACT

The bystander effect is a social psychological phenomenon in which individuals are less likely to help a person potentially in need if there are others present. Sociologists and psychologists have proposed multiple plausible reasons for the bystander effect, from situational ambiguity and social contagion to diffusion of responsibility and mutual denial. We build a new model of an individual’s decision to intervene in a bystander situation based on these social psychological hypotheses, along with ideas borrowed from prospect theory. The model yields an explicit bystander curve, which demonstrates, for the first time, that the bystander effect emerges from social risk perception among non-coordinating individuals in ambiguous bystander situations. Expanding upon this static model, we explore the effect of social learning, where individuals update their perceived risk of intervening after experiencing or witnessing the social repercussions of previous interventions. A novel result of this piecewise-smooth dynamical system model, with threshold-driven switching behavior, is that social learning exacerbates the bystander effect. We validate both the static and dynamic models using a new database of 42 experimental and observational studies across a wide range of bystander situations, demonstrating the importance of both population heterogeneity and social learning rates on the emergence of observed bystander curves. This provides a straightforward and generalizable explanation for the observed phenomenon, which may suggest effective interventions tailored to specific bystander situations.

PMID:42030065 | DOI:10.1063/5.0323615

JAMA Health Forum. 2026 Apr 3;7(4):e260874. doi: 10.1001/jamahealthforum.2026.0874.

ABSTRACT

IMPORTANCE: To increase the use of home dialysis and kidney transplant, the Centers for Medicare & Medicaid Services launched the End-Stage Renal Disease Treatment Choices (ETC) model, a mandatory, randomized pay-for-performance program applied to 30% of US hospital referral regions. Its impact after 4 years of implementation is uncertain.

OBJECTIVE: To assess the ETC model’s impact on home dialysis, kidney transplant, and transplant waitlist, as well as measure the rate of financial penalties.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study used traditional Medicare claims and enrollment data for beneficiaries with kidney failure linked to concurrent transplant data from the United Network for Organ Sharing from January 1, 2017 (4 years before model implementation), to September 30, 2024 (3.75 years postimplementation).

EXPOSURES: Receiving dialysis treatment in a region randomly assigned to the ETC model.

MAIN OUTCOMES AND MEASURES: Primary outcomes were rates of home dialysis, kidney transplant, and transplant waitlist, as well as facility-level financial penalization. Facility-level financial penalties were assessed using Centers for Medicare & Medicaid Services-published performance data.

RESULTS: The study population included 795 232 persons with kidney failure (mean [SD] age, 61.8 [14.4] years; 41.5% female), reflecting 20 729 696 person-months from January 1, 2017, to September 30, 2024. The rate of home dialysis increased from 12.8% to 16.7% of attributed patient-months in ETC regions (change of 3.9 percentage points [pp]) and from 13.7% to 17.3% in control regions (change of 3.7 pp), yielding an adjusted differences-in-differences of -0.1 pp (95% CI, -0.6 to 0.5 pp). The number of kidney transplants per 1000 patient-months increased from 3.3 to 4.5 in ETC regions (change of 1.2) and from 3.4 to 4.4 in control regions (change of 1.0), resulting in a differences-in-differences of 0.2 pp (95% CI, -0.1 to 0.4 pp). The percentage of patients per month on the transplant waitlist decreased from 16.1% to 15.5% in ETC regions (change of -0.5 pp) and from 17.7% to 16.7% in control regions (change of -1.0 pp). The adjusted differences-in-differences for transplant waitlist was 0.6 pp (95% CI, -0.3 to 1.6 pp). The proportion of ETC facilities receiving financial penalties increased from 13.8% in 2021 to 25.1% in 2023. Subgroup analyses showed no meaningful differential effects of the model.

CONCLUSIONS AND RELEVANCE: This cross-sectional study shows that after nearly 4 years, the ETC model was not associated with meaningful increases in home dialysis, kidney transplant, or transplant waitlist, while the proportion of facilities receiving financial penalties increased. Future value-based payment models may need to move beyond narrowly targeted financial incentives to address the broader structural and patient-level barriers that influence access to complex specialty care.

PMID:42030054 | DOI:10.1001/jamahealthforum.2026.0874