Tag: pubmed

J Med Internet Res. 2026 Jun 1;28:e68051. doi: 10.2196/68051.

ABSTRACT

BACKGROUND: Phishing remains a dominant initial attack vector in health care, exploiting psychological factors such as urgency and authority. Despite extensive investment in technical controls and awareness training, health care staff remain highly susceptible in real operational conditions. Cognitive dissonance (CD), the discomfort arising from inconsistencies between beliefs and actions, has been proposed as a mechanism to disrupt unsafe rationalization at the moment of exposure, but has rarely been evaluated in live organizational settings using objective behavioral outcomes.

OBJECTIVE: This study examined whether a brief CD-based priming intervention, delivered immediately prior to a real-world phishing simulation, was associated with differences in phishing susceptibility among health care staff. Secondary objectives explored whether CD exposure was associated with directional differences in security-related perceptions and self-reported practices.

METHODS: A 2-stage hybrid randomized-encouragement experiment was conducted at a large Norwegian hospital. In Stage 1, staff were randomly assigned to a control or CD-primed condition and completed a survey assessing security perceptions and self-reported practices (n=62). In Stage 2, an in-the-wild phishing simulation was sent to all staff, enabling objective measurement of phishing susceptibility via observed link-click behavior. Behavioral outcomes were analyzed across 3 groups-control (n=34), CD-primed (n=32), and neutral nonresponders (n=753)-using a prespecified omnibus chi-square test as the sole confirmatory analysis. Survey-based multivariate and univariate analyses were treated as exploratory due to limited sample size and variable construct reliability.

RESULTS: Due to voluntary uptake, only a subset of randomized participants received the intervention. Observed phishing click rates were 65% (22/34) in the control group, 44% (14/32) in the CD-primed group, and 53% (396/753) in the neutral group. The omnibus chi-square test did not detect a statistically significant association between group membership and click behavior (χ²2=3.00; n=819; P=.22; Cramér V=0.06). Descriptive comparisons within the randomized subset suggested lower click rates in the CD-primed group, but effect estimates were imprecise and associated with wide CIs. Survey-based analyses indicated group differences across combined psychological constructs; however, several constructs exhibited low internal consistency, and follow-up analyses were underpowered.

CONCLUSIONS: In a real-world hospital phishing simulation, pre-exposure CD priming was associated with a directional but statistically nonsignificant pattern of reduced phishing click behavior. This evidence does not establish a reliable behavioral effect, and construct-level findings are exploratory. CD-based prompts may serve as a lightweight behavioral signal in real-world conditions, but larger, fully randomized, and longitudinal studies with improved psychometric validation are needed before such interventions can be considered reliable complements to established cybersecurity controls.

PMID:42224651 | DOI:10.2196/68051

JCO Oncol Pract. 2026 Jun 1:OP2501315. doi: 10.1200/OP-25-01315. Online ahead of print.

ABSTRACT

PURPOSE: Sotorasib represents an early example in which the US Food and Drug Administration (FDA) requested formal dose optimization under Project Optimus. Although 960 mg remains the labeled dose, tolerability is often challenging. After the FDA Oncologic Drugs Advisory Committee discussion of CodeBreak100 part B, Ratain and Popat argued there was no clear basis for doses above 240 mg. We conducted a systematic review and meta-analysis comparing the efficacy and tolerability of standard versus reduced starting doses of sotorasib in KRAS G12C-mutated non-small cell lung cancer.

METHODS: We conducted a systematic search of PubMed, EMBASE, SCOPUS, CINAHL, and Web of Science through October 28, 2025. Eligible studies included randomized trials, prospective studies, and retrospective studies reporting objective response rate (ORR), progression-free survival (PFS), and treatment-related adverse events (TRAEs). Pooled estimates were calculated using a random-effects model.

RESULTS: Among 5,133 studies screened, 145 studies were reviewed, with 10 studies meeting inclusion criteria. The pooled ORR was 33% (95% CI, 29% to 36%) for patients starting at 960 mg (n = 1,347) versus 26% (95% CI, 19% to 34%) for those starting at reduced dose (n = 130), similar to the dose-optimization study (32.7% v 24.8%). There was no statistically significant improvement in ORR with the higher dose (risk ratio, 1.26 [95% CI, 0.87 to 1.83]). Similarly, pooled PFS did not favor 960 mg dosing (hazard ratio, 0.77 [95% CI, 0.56 to 1.05]). At 960 mg dose, TRAEs were common, with any-grade and grade ≥3 TRAE in 83% and 22%, respectively, with dose reductions in 17% and discontinuation in 10% of patients.

CONCLUSION: The labeled 960 mg dose did not demonstrate meaningful improvement in efficacy, while toxicity remained substantial. These findings support efforts under Project Optimus to identify the lowest effective dose. Lower doses, including 240 mg, may provide comparable outcomes while reducing toxicity, pill burden, and treatment costs.

PMID:42224643 | DOI:10.1200/OP-25-01315

JCO Clin Cancer Inform. 2026 Apr;10(2):e2500139. doi: 10.1200/CCI-25-00139. Epub 2026 Jun 1.

ABSTRACT

PURPOSE: Cancer registries are often asked to present cancer data for small geographic areas to inform and facilitate targeted interventions and prevention programs. However, it is challenging to compute and visualize reliable cancer estimates for areas with small case counts and populations to support cancer control planning.

METHODS: Leveraging a user-centered design process, we developed a visual analytics platform and interactive graphics to display modeled cancer risk estimates for small areas. Development of our visual analytics platform was informed by cancer registry and public health professionals through focus groups and surveys. The reliable cancer risk estimates for small areas that we displayed on this platform were created using a Bayesian hierarchical model that borrows strength from neighboring areas and over time to produce cancer estimates for small areas.

RESULTS: The Cancer Analytics and Maps for Small Areas tool (CAMSA) provided age-adjusted cancer incidence and mortality rates and risk probabilities for eight cancers at the county and ZIP-code tabulation area levels. It allowed the user to identify areas of high cancer incidence, including among subgroups defined by sex and race/ethnicity. Potential end users were enthusiastic about the opportunity to implement CAMSA within their practice, emphasizing the tool’s potential for increased collaborative opportunities at local and state levels. Suggestions for improvement included adding map overlays such as additional cancer risk variables and incorporating functionalities such as exportable data tables.

CONCLUSION: CAMSA presented cancer rate and risk estimates for small geographic areas where they may have previously been suppressed. Through our user-centered design process, we developed statistical models and data visualizations to support the needs of an array of potential end users.

PMID:42224633 | DOI:10.1200/CCI-25-00139

Chron Respir Dis. 2026 Jan-Dec;23:14799731261453571. doi: 10.1177/14799731261453571. Epub 2026 Jun 1.

ABSTRACT

ObjectivesTo determine whether a remote behaviour change service (Active Steps), delivered by a UK charity, can increase physical activity over a 12-month period in adults with lung disease.MethodsActive Steps (n=166) consisted of 1:1 telephone health coaching for 12 months alongside printed (e.g. activity diary and chart, information and goal setting booklet) and digital behaviour change strategies (e.g. exercise videos, motivational newsletters, pedometer). A concurrent control group was recruited (n=80) for comparison. Self-reported physical activity (Short Active Lives Survey) and self-reported health (EQ-VAS) were collected at baseline, 3, 6, and 12 months. Logistic regression models (adjusted for confounders) were used to analyse the odds of becoming physically active or average changes in physical activity time and EQ-VAS.ResultsPrimary outcome: The number of participants defined as physically active at 12 months was greater with Active Steps (46%) compared to controls (23%) which was statistically significant in an unadjusted (odds ratio (OR) [95% confidence intervals (CI)]:2.8 [1.3-6.1], p=0.011) but not adjusted model (OR: 2.2 [0.9-5.4], p=0.097). Secondary outcomes: Compared to controls, Active Steps increased the number of participants physically active at 3 and 6 months, increased the weekly minutes of moderate-vigorous physical activity and improved self-reported health (EQ-VAS) across all timepoints.DiscussionOur findings suggest that charity-led remote behaviour change support is effective in the short-to-medium-term in adults with lung disease, but high participant attrition necessitates caution in interpreting sustained effect estimates at 12 months. Further long-term evaluations are needed to address adherence and sustainability of such services.

PMID:42224628 | DOI:10.1177/14799731261453571

Proc Natl Acad Sci U S A. 2026 Jun 9;123(23):e2518179123. doi: 10.1073/pnas.2518179123. Epub 2026 Jun 1.

ABSTRACT

Childhood stunting is associated with increased mortality, higher risk of chronic disease, impaired cognitive development, lower educational attainment, reduced economic opportunities, and intergenerational transmission of stunting. These risks are likely to intensify as climate change exacerbates key drivers of undernutrition, making it important to understand how rising temperatures affect stunting and the role of socioeconomic inequality in this relationship. We analyze data from 34 African countries from 2004 to 2020 using Demographic and Health Surveys (DHS), combining observed temperature variability from ERA5 reanalysis with anthropogenic temperature anomalies derived from Detection and Attribution Model Intercomparison Project (DAMIP) simulations. Using a mediation framework, we examine pathways linking temperature anomalies, inequality, and child stunting. Results based on observed temperature anomalies show no direct climate effect on stunting or inequality, but a positive and statistically significant association between inequality and stunting. In contrast, anthropogenic temperature anomalies are positively associated with inequality and stunting, with a 1 °C increase linked to a 3.45% rise in child stunting (SE = 1.52, P = 0.023), with no evidence of mediation through inequality. Notably, we find a consistent positive association between inequality and stunting across specifications. These findings suggest that reducing inequality, together with investments in education, sanitation, and household resilience, could substantially lower stunting rates and protect child health in a warming world.

PMID:42224608 | DOI:10.1073/pnas.2518179123

Opt Lett. 2026 Jun 1;51(11):3253-3256. doi: 10.1364/OL.592295.

ABSTRACT

This work investigates the enhancement of channel capacity in photon-starved deep-space optical links by leveraging inter-photon correlations. We analyze an M-ary pulse-position modulation (PPM) photon-counting channel in the presence of Poisson background noise and compare conventional signal sources with recently proposed correlated photonic-dimer sources. In the low-photon-rate regime, the dimer sources in both the Bose-Einstein condensate (BEC) and Bardeen-Cooper-Schrieffer (BCS) limits yield substantial capacity improvements over conventional sources. Specifically, at the operationally relevant PPM order of M = 128, the increase relative to lasers reaches up to ∼37% (BEC) and ∼94% (BCS), respectively. These results underscore photon-statistics and correlation engineering as a promising degree of freedom for maximizing photon information efficiency under stringent power and transceiver constraints.

PMID:42224570 | DOI:10.1364/OL.592295

Toxicol Ind Health. 2026 Jun 1:7482337261453776. doi: 10.1177/07482337261453776. Online ahead of print.

ABSTRACT

The potential of the neonicotinoid insecticide dinotefuran to induce oxidative DNA damage was evaluated in human peripheral blood lymphocyte cultures at three concentrations (0.05, 0.15, and 0.30 µg/mL) using the single-cell gel electrophoresis assay (COMET). Its ability to interact with DNA was further examined through molecular docking analysis. The comet assay results revealed statistically significant increases (p < 0.001) in both the genetic damage index (GDI) and the percentage of heavily damaged cells (DCP) at all tested concentrations compared with the negative control. DNA damage within individual cells caused by genotoxic agents can thus be effectively detected using the comet assay, as demonstrated in our study. Additionally, the optimized molecular structure, total energy, molecular orbital energies, molecular electrostatic potential (MEP) maps, and global reactivity parameters of dinotefuran were obtained using the DFT/B3LYP/6-311G(d,p) method. The fully optimized energy was predicted, and geometric parameters were compared with available single-crystal structure data. Computational studies employing density functional theory (DFT) and MEP analyses provided detailed insights into the geometric and electronic characteristics of dinotefuran, suggesting that the compound possesses significant chemical reactivity and potential for biological activity upon interaction with DNA. Molecular docking studies with the B-DNA dodecamer (PDB ID: 1BNA) yielded a minimum binding energy of -6.24 kcal/mol. Dinotefuran was found to form four conventional hydrogen bonds, two carbon-hydrogen bonds, and one π-donor hydrogen bond with DNA, primarily involving guanosine, cytosine, and thymidine bases. These interactions are consistent with the experimental evidence of genetic-oxidative DNA damage, indicating that dinotefuran can establish strong molecular interactions with DNA.

PMID:42224505 | DOI:10.1177/07482337261453776

Dev Psychol. 2026 Jun 1. doi: 10.1037/dev0002217. Online ahead of print.

ABSTRACT

The goal of this study was to explore the possible moderating and mediating roles of processing speed in children’s interval timing performance. Nine- to 11-year-old children (N = 103; 53% male; 67% White, 4% Black, 5% Asian, 3% Hispanic, 9% biracial/mixed identity, 12% unknown) performed behavioral interval timing, executive functioning, and processing speed tasks, along with a movement skills assessment. We found that processing speed moderated the relation between movement skills and interval timing such that poorer movement skills most strongly predicted more variable interval timing in children with very slow processing speed. Processing speed also statistically mediated the relation between poorer executive functions (working memory and inhibitory control) and more variable interval timing. This suggests that children with movement difficulties who also have very slow processing speed may be most at risk for dysfunctions in timing-based movement skills and that slow processing speed may interfere with efficient operation of executive functions involved in interval timing skills. We discuss the possible role that processing speed may play in understanding individual variation in children’s interval timing skills and how combined difficulties in timing skills, motor ability, and processing speed may represent a particularly at-risk profile for children with neurodevelopmental disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42224002 | DOI:10.1037/dev0002217

Hum Factors. 2026 Jun 1:187208261452147. doi: 10.1177/00187208261452147. Online ahead of print.

ABSTRACT

ObjectiveTo identify eye movement patterns that are correlated with spatial disorientation (SD) events during flights in a flight simulator that induces SD.BackgroundSpatial Disorientation is one of the main causes for aviation mishaps. It can result from illusions caused by misinterpreted vestibular or visual sensory cues, leading to an incorrect perception of an aircraft’s position, attitude, or motion. SD prevention is of great importance, as there is currently no objective tool to identify its occurrence.MethodEye movements of 45 participants (30 aircrew members, 15 cadets) were recorded using Tobii Pro Glasses 2 in a Gyro-IPT SD flight simulator. Illusions were either vestibular or visual. Gaze metrics such as fixations, saccades (rapid gaze shift between two points), and visits were compared between subjects who experienced SD and those who did not. Statistical analyses were conducted to identify significant differences.ResultsAmong 284 flight profiles, 136 SD occurrences were recorded (48%). During visual illusions the participants who more frequently checked the instrument panel had a higher chance of avoiding SD. In contrast, during vestibular illusions, participants who examined the head-up display (HUD) more frequently had a lower probability of SD occurrence.ConclusionMitigating SD requires distinct eye-movement strategies tailored to the illusion type. Our results suggest that to mitigate visual illusions, there is a need for greater instrument panel focus, whereas to mitigate vestibular illusions, increased HUD engagement is needed, as opposed to the current instructions.ApplicationOur findings may inform training programs to enhance performance in high-risk SD flight profiles. Additionally, results support the potential development of a real-time SD alert system for aircraft, aiming to mitigate or prevent SD-related incidents.

PMID:42223995 | DOI:10.1177/00187208261452147

J Craniofac Surg. 2026 Jun 1. doi: 10.1097/SCS.0000000000012978. Online ahead of print.

ABSTRACT

BACKGROUND: Ear anomalies, common in newborns, affect psychosocial development. While otoplasty carries surgical risks, nonsurgical molding within the first weeks of life effectively corrects many deformities using splints like the EarWell system. However, success is time-sensitive, and technique standardization is lacking. This meta-analysis compares commercial systems and custom procedures, evaluating success rates and complications for different auricular anomalies.

METHODS: The authors searched for relevant articles up to October 2025 from PubMed, Scopus, and Web of Science. Two independent reviewers extracted data from the selected studies, including baseline information, outcomes, success rates, complications, and parental satisfaction metrics. All data analyses were performed using R version 4.3.3.

RESULTS: The authors collected 1208 records after excluding 795 duplicates. Thorough screening resulted in the retrieval of 49 entries eligible for inclusion in our review. Our analysis found high success rates across all methods. The EarWell system achieved 93% success, custom methods 91%, and other commercial systems 88%, with no statistically significant differences (P=0.155). Good-to-excellent outcomes occurred in 95% of cases. EarWell was more effective for deformations (96%) than malformations (82%), while custom methods reached 97% for deformations. Parental satisfaction was high overall (89%) but differed significantly by method (P=0.017), with custom methods at the forefront at 96%, followed by EarWell (88%) and other commercial systems (81%). However, meta-regression showed EarWell was associated with 1.6 times higher parental satisfaction odds (OR: 1.593, P=0.024). Complication rates were 13% for EarWell and other commercial systems, and 8% for custom methods (P=0.567). Longer treatment duration slightly reduced overall success odds (OR: 0.996, P=0.023). Device type and age at intervention did not significantly affect outcomes.

CONCLUSION: Nonsurgical ear molding is safe and effective. Since custom splints match commercial devices in efficacy, low-cost methods are viable alternatives.

PMID:42223983 | DOI:10.1097/SCS.0000000000012978