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Nevin Manimala Statistics

Impact of 340B Exposure on Treatment Utilization and Cost for Medicare Patients With Cancer

Health Serv Res. 2026 Feb;61(1):e70092. doi: 10.1111/1475-6773.70092.

ABSTRACT

OBJECTIVE: To investigate how exposure to the 340B Drug Pricing Program influences care for patients with the two most common forms of cancer: lung and breast.

STUDY SETTING AND DESIGN: Proponents of the 340B Program assert that it reduces care costs by supporting safety-net providers through outpatient drug discounts. There is a gap in understanding patient-level program impacts. We estimate the association between the 340B program and care utilization, treatment costs, and health outcomes by comparing patients exposed to the 340B program to patients not exposed using linear and logistic multivariate regression analyses with propensity score weighting. Costs are inflation-adjusted to U.S. 2020 dollars.

DATA SOURCES AND ANALYTIC SAMPLE: We use Medicare fee-for-service claims data for beneficiaries in the United States who are within one year of an initial lung (N = 35,334) or breast (N = 83,721) cancer diagnosis between 2013 and 2018.

PRINCIPAL FINDINGS: Exposure to the 340B program is associated with a significant increase in the probability of using Part B-covered cancer treatment drugs of 10.8 percentage points (pp) (95% CI, 9.2 pp. to 12.3 pp) for lung cancer and 14.8 pp. (95% CI, 13.9 pp. to 15.6 pp) for breast cancer. This is a relative increase of 19.6% and 43.1% for lung and breast cancer, respectively. Medicare spent $9592 (95% CI, $8498 to $10,686) more on lung cancer and $7598 (95% CI, $7215 to $7980) more on breast cancer patients exposed to the 340B program compared with patients not exposed, where the average cost of treatment was $36,256 and $15,626 for lung and breast cancer, respectively.

CONCLUSIONS: Findings are consistent with the financial incentives of the 340B program and highlight that the program has a broad impact on patient care and cost. Policymakers should consider ways to support safety net providers that are not tied to outpatient medications.

PMID:41693003 | DOI:10.1111/1475-6773.70092

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Nevin Manimala Statistics

Exploring Older Adults’ Engagement with Socially-Assistive-Robots using AI: Personas, Patterns, and Psychosocial Outcomes

Gerontologist. 2026 Feb 15:gnag009. doi: 10.1093/geront/gnag009. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The digital divide and limited AI literacy pose significant barriers to technology adoption among older adults in low-resource communities. This study investigates the potential of socially assistive robots (SARs) to promote social engagement and psychosocial well-being by analyzing interactions with the AI-driven Hyodol SAR.

RESEARCH DESIGN AND METHODS: Multimodal data-including log-based usage patterns and voice recordings-were collected via SAR-embedded sensors. Pre- and post-intervention surveys provided demographic and health information. Human-robot conversations were classified into nine emotional and topical categories, along with six types of activity participation. K-means clustering was employed to identify distinct user personas reflecting engagement patterns.

RESULTS: Of the participants, 44.6% engaged in conversation with the SAR, and 30.2% discussed activity participation. Three user personas emerged: Social Engagers (28.35%) balanced social and personal interactions with positive emotional tone; Independent Reflectors (41.79%) showed high conversational engagement; Emotionally Expressive Users (29.85%) demonstrated the highest overall SAR usage, including tactile and content-based interactions. While some clusters exhibited numerical reductions in loneliness and depression, these changes did not reach statistical significance.

DISCUSSION AND IMPLICATIONS: These findings suggest that SARs can complement caregiving services for older adults in low-resource communities. By integrating narrative data with quantitative survey responses and usage logs, this study advances methodological approaches in AI-driven gerontological research. The results highlight opportunities for persona-based customization, AI-adaptive learning, and emotion-informed care in future SAR development.

PMID:41692979 | DOI:10.1093/geront/gnag009

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Nevin Manimala Statistics

Moiraine: an R package to construct reproducible pipelines for the application and comparison of multi-omics integration methods

Bioinformatics. 2026 Feb 15:btag070. doi: 10.1093/bioinformatics/btag070. Online ahead of print.

ABSTRACT

MOTIVATION: In the past decades, many statistical methods for integrating multi-omics data have been developed. They have been implemented into software tools, which differ widely in their programming choices, such as the format required for data input, or the format of the generated integration results. This lack of standards renders cumbersome and time-intensive the application and comparison of different integration tools to a same multi-omics dataset.

RESULTS: We have developed the moiraine R package for constructing reproducible multi-omics integration pipelines, which enables users to apply one or more statistical methods for multi-omics integration to their own multi-omics dataset. moiraine facilitates the pre-processing of the omics datasets, and automates their formatting for the integration step. It simplifies the interpretation and evaluation of the integration results, through the construction of visualisations in which metadata about samples and features can easily be included. Crucially, it enables the comparison of results obtained with different integration tools, allowing users to assess the robustness of their results.

AVAILABILITY AND IMPLEMENTATION: The moiraine R package is publicly available at https://github.com/Plant-Food-Research-Open/moiraine; an archival snapshot of the package is available on Zenodo at https://doi.org/10.5281/zenodo.17172718. A detailed tutorial is available at https://plant-food-research-open.github.io/moiraine-manual/.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:41692950 | DOI:10.1093/bioinformatics/btag070

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Nevin Manimala Statistics

Interventions Promoting Work Engagement and Reducing Turnover of Newly Graduated Nurses: A Systematic Review

Nurs Open. 2026 Feb;13(2):e70434. doi: 10.1002/nop2.70434.

ABSTRACT

AIM: To evaluate the effectiveness of interventions to enhance and maintain organisational commitment, work engagement and retention and to reduce burnout and turnover of newly graduated nurses (NGNs).

BACKGROUND: Nurses leave their profession at a rate of 5%-18% worldwide. NGNs transferring from being a nurse student to a registered nurse may face significant stress and difficulties. To support a successful transition and reduce turnover rates among new graduates, it is necessary to identify effective interventions to enhance and maintain organisational commitment, work engagement and retention of NGNs and to reduce their burnout and turnover.

METHODS: The systematic review focused on newly graduated nursing professionals having worked within clinical practice at most 6 months after their graduation, in any social or health care setting. We excluded studies focusing solely on nursing assistants, licensed practical nurses, advanced nurse practitioners, or clinical nurse specialists. Of the interventions, residency programmes were excluded. Cochrane Library, CINAHL, MEDLINE, Scopus, the Joanna Briggs Institute and Medic were searched with a timeline from January 2012 to February 2023. Quality appraisal of the original studies was performed using specific criteria for each study design. The results of the original studies were synthesised narratively. Effect size was estimated with Cohen’s d (d).

RESULTS: The review included three moderate to good quality original studies with 566 participants in total: a randomised controlled trial, a non-randomised trial and a cohort study. Two interventions based on one-to-one mentoring strategy (d = -0.18) and 10-minute preceptor model using educational strategies (d = -0.58) showed small or medium effects towards decreased turnover intentions. Psychological measures of work engagement, burnout or organisational commitment had not been addressed as an outcome in any of the studies.

CONCLUSION: We found very few good-quality studies examining interventions to promote NGN’s staying at work. Of the three studies, two showed an association with lower turnover. More research with high-quality study designs is needed. The evaluations should include cost-benefit analysis.

IMPLICATIONS FOR NURSING MANAGEMENT: The current evidence is insufficient to make recommendations for nursing management on interventions to promote NGN’s staying at work. Thus, further research is needed to build evidence-based interventions.

REGISTRATION: PROSPERO Registration CRD42022328406.

PMID:41692946 | DOI:10.1002/nop2.70434

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Nevin Manimala Statistics

Indocyanine green in intestinal endometriosis surgery: a multicenter evaluation of anastomotic safety

J Robot Surg. 2026 Feb 16;20(1):253. doi: 10.1007/s11701-025-03136-0.

ABSTRACT

OBJECTIVE: To evaluate whether the use of intraoperative indocyanine green (ICG) fluorescence impacts anastomotic safety and surgical outcomes in patients undergoing bowel endometriosis resection.

METHODS: Retrospective, multicenter observational study conducted in tertiary referral hospitals in the state of São Paulo, Brazil. A total of 1,090 patients who underwent surgery for bowel endometriosis between 2021 and 2025 were included, of whom 301 received ICG fluorescence assessment and 789 did not.

INTERVENTIONS: Surgical management of bowel endometriosis using shaving, discoid nodulectomy, or segmental resection, performed via laparoscopy or robotic surgery. Intraoperative fluorescence was used as an adjunct for bowel perfusion assessment during surgery.

RESULTS: Clinical variables, surgical technique, specimen extraction route, complications (classified by Clavien-Dindo), and length of hospital stay were analyzed. Patients in the ICG group underwent more complex procedures, with higher rates of segmental resection (53.2% vs. 17.3%; p < 0.001) and natural orifice specimen extraction (53.4% vs. 36.9%; p = 0.004). Overall postoperative morbidity, including anastomotic fistula (1.0% vs. 0.8%; p = 0.703) and reoperation (2.0% vs. 1.0%; p = 0.201), was similar between groups. After adjustment for surgical technique, ICG use was not independently associated with prolonged hospitalization.

CONCLUSION: The application of indocyanine green fluorescence in bowel endometriosis surgery was safe and did not increase postoperative morbidity. Its use was concentrated in technically demanding cases, supporting its role as an adjunct for intraoperative perfusion assessment rather than a determinant of surgical outcomes.

PMID:41692930 | DOI:10.1007/s11701-025-03136-0

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Nevin Manimala Statistics

Effectiveness of integrated continuity of care in ambulatory robotic partial nephrectomy: a single-center retrospective cohort study

J Robot Surg. 2026 Feb 16;20(1):260. doi: 10.1007/s11701-026-03161-7.

ABSTRACT

OBJECTIVE: To compare the outcomes between the traditional hospitalization care model and an ambulatory surgery model with integrated continuity of care for patients undergoing robot-assisted partial nephrectomy (RPN).

METHODS: This retrospective cohort study analyzed the clinical data of 120 consecutive patients who underwent robot-assisted partial nephrectomy at our hospital between June 2021 and June 2024. Patients were divided into two groups based on the perioperative care model they received: a control group (n = 55) receiving routine care within the traditional hospitalization model and an observation group (n = 65) managed under the ambulatory surgery model with integrated continuity of care. A propensity score-matched analysis was performed to control for potential selection bias. The OAS CAHPS was used to investigate patient evaluations regarding medical care, preoperative preparation, postoperative education, and discharge guidance. Based on the characteristics of the statistical data, analysis was performed using statistical packages in R software. Outcome measures included wound healing status, pain scores, ability to perform activities of daily living (ADL), and patient satisfaction.

RESULTS: Groups were comparable at baseline and after matching. The intervention group demonstrated a significantly shorter median postoperative stay (29 vs. 94 h), time to first ambulation (8 vs. 25 h), and lower hospitalization costs (all P < 0.05). They also had superior functional recovery, lower pain scores, and higher satisfaction (all P < 0.05). An initial association with improved wound healing at 1 month was attenuated in the matched analysis.

CONCLUSION: For patients undergoing RPN, the ambulatory surgery model with integrated continuity of care was associated with accelerated recovery, improved functional outcomes, and higher patient satisfaction compared to the traditional hospitalization care model. Its association with improved wound healing requires further validation. This integrated care approach is worthy of further prospective validation and application.

PMID:41692927 | DOI:10.1007/s11701-026-03161-7

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Nevin Manimala Statistics

Age disparity in robotic colorectal surgery: overcoming surgeon hesitancy to improve elderly patient outcomes

J Robot Surg. 2026 Feb 16;20(1):254. doi: 10.1007/s11701-026-03217-8.

NO ABSTRACT

PMID:41692915 | DOI:10.1007/s11701-026-03217-8

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Nevin Manimala Statistics

Refining risk assessment: bridging statistical innovation and clinical reality

Prostate Cancer Prostatic Dis. 2026 Feb 15. doi: 10.1038/s41391-026-01088-6. Online ahead of print.

NO ABSTRACT

PMID:41692906 | DOI:10.1038/s41391-026-01088-6

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Nevin Manimala Statistics

ESR Innovation in Focus: Robotics applications for interventional radiology

Eur Radiol. 2026 Feb 16. doi: 10.1007/s00330-026-12326-9. Online ahead of print.

NO ABSTRACT

PMID:41692898 | DOI:10.1007/s00330-026-12326-9

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Nevin Manimala Statistics

ESR Innovation in Focus: photon-counting detector CT

Eur Radiol. 2026 Feb 16. doi: 10.1007/s00330-025-12197-6. Online ahead of print.

NO ABSTRACT

PMID:41692897 | DOI:10.1007/s00330-025-12197-6