Categories
Nevin Manimala Statistics

Structured Education Enhances Inhaler Technique and Asthma Management Skills of Health Care Providers in Pediatric Emergency Departments

Pediatr Pulmonol. 2026 Aug;61(8):e71803. doi: 10.1002/ppul.71803.

ABSTRACT

BACKGROUND: Optimal inhaler technique (IT) is essential for effective asthma management, yet skill retention among health care professionals (HCPs) remains inconsistent.

AIM: To compare the long-term effectiveness of intensive versus brief educational interventions on IT retention among HCPs in pediatric emergency departments (PEDs) across Northern Greece.

METHODS: We conducted a 12-month prospective, multicenter intervention study in 20 PEDs. Pediatric consultants, residents, and nurses were allocated to either an intensive education group-receiving IT training every 4 months-or a brief education group-receiving a single training session. Blinded assessments of IT skills were performed alongside structured questionnaires on asthma crisis management and IT with both a facemask and a mouthpiece. Final evaluations were conducted at 12 months.

RESULTS: A total of 373 HCPs participated: 84 consultants, 178 residents, and 111 nurses. Post-intervention scores improved significantly for consultants (asthma crisis management: 69.94 to 76.54, p = 0.006; IT with facemask: 37.5 to 50, p = 0.003; IT with mouthpiece: 50 to 75, p = 0.005) and residents (61.15 to 70.89, p = 0.004; 25 to 50, p = 0.005; 50 to 75, p = 0.01, respectively). Intensive education was associated with significantly greater improvements compared with brief education, particularly among consultants (p = 0.003 for asthma crisis management). Nurses did not demonstrate statistically significant improvements.

CONCLUSIONS: Intensive, repeated training produces superior long-term retention of IT skills among HCPs in PEDs compared with a single educational session. Incorporating structured, ongoing educational strategies into routine practice may enhance asthma care delivery and reduce reliance on nebulizers in acute pediatric settings.

PMID:42634896 | DOI:10.1002/ppul.71803

Categories
Nevin Manimala Statistics

Sleep disturbance in CKD: patient‑prioritized outcomes, management, and perceptions – a multicenter mixed-methods study in Australia

Ren Fail. 2026 Dec;48(1):2714693. doi: 10.1080/0886022X.2026.2714693. Epub 2026 Aug 24.

ABSTRACT

BACKGROUND: Sleep disturbances are common in chronic kidney disease (CKD), yet patient priorities, reporting behaviors, and experiences of sleep management remain poorly understood. This study explored perceived causes of sleep disturbance, patient-prioritized sleep outcomes, and experiences of reporting and managing sleep problems.

METHODS: A multicenter, convergent mixed-methods study of adults with CKD stage 4-5, including those receiving kidney replacement therapy. Participants were recruited from four nephrology units across three Australian states. Survey data were analyzed using descriptive statistics and subgroup comparison, and interview data using thematic analysis, with findings integrated through triangulation.

RESULTS: A total of 234 participants completed the survey and 14 participated in interviews. Participants were predominantly male (67%), aged over 60 years, and receiving hemodialysis (62%). Overall, 73% were classified as poor sleepers. Fragmented sleep (56%), nocturia (44%), and restless legs syndrome (27%) were the most common contributors. Feeling refreshed on waking and satisfaction with sleep were the highest-priority outcomes, ranked above social participation, ability to work, and hospital admissions. Forty-one percent reported that their treating team had never asked about sleep, and among those who raised concerns, almost one-quarter received no management. Pharmacological therapy was the most commonly reported clinical management (33%), despite a preference for nonpharmacological strategies. Nine percent used a wearable sleep tracker; with a further 41% willing to try one.

CONCLUSION: In this cohort, sleep disturbances were common, under-recognised, and inconsistently managed. Management approach does not fully align with patient preferences. Greater access to nonpharmacological approaches and wearable technologies may support monitoring and engagement.

PMID:42634875 | DOI:10.1080/0886022X.2026.2714693

Categories
Nevin Manimala Statistics

Effect of Wearable Devices and 5G-Powered Remote Precision Rehabilitation on Vascular Function in Post-PCI Patients: An Analysis of the Associations Between FMS, Cardiorespiratory Fitness, and Arterial Stiffness

FASEB J. 2026 Aug 31;40(16):e72181. doi: 10.1096/fj.202602684RR.

ABSTRACT

To explore the effects of personalized exercise prescriptions and 5G-supported remote rehabilitation on adherence, lipid levels, cardiorespiratory fitness, and vascular function in patients after percutaneous coronary intervention (PCI), as well as to conduct a correlation analysis. This study employed a randomized, prospective clinical trial design, enrolling 155 patients at the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from September 2024 to September 2025. Patients were divided into a conventional group (n = 81) and a 5G remote monitoring group (n = 74), with the intervention lasting for 12 months. The 5G group utilized wearable devices for real-time monitoring. There were no statistically significant differences in baseline characteristics between the two groups (p > 0.05), indicating comparability. Correlation analysis revealed strong positive correlations among peak oxygen uptake (peak VO2), peak work rate (Peak WR), oxygen uptake at anaerobic threshold (VO2 at AT), and peak metabolic equivalents (peak METs) in the overall observed parameters (r > 0.8); peak VO2 was positively correlated with left ventricular ejection fraction (LVEF) (r > 0.4). Vascular function showed positive correlations between Flow-Mediated Slowing of pulse wave velocity (FMS) and left atrial diameter (LA), the ratio of early mitral inflow velocity to mitral annulus velocity (E/e’), and left ventricular end-diastolic diameter (LVEDD), while carotid-femoral pulse wave velocity (cf-PWV) was negatively correlated with CPET parameters, and there was a strong positive correlation between bilateral ankle-brachial index (ABI). The Gini index ranking indicated that cf-PWV, LVEF, age, peak VO2, and Peak WR had the most significant impact on FMS. After a 12-month follow-up, the improvements in LDL-C in the traditional group were superior to those in the 5G remote monitoring group (p < 0.05). However, the 5G remote monitoring group showed significant improvements in LVEF, E/e’, LA, LVEDD, FMS, and cf-PWV compared to the traditional group (all p < 0.05). Factor analysis indicated that in the 5G remote monitoring group, VO2 at AT and Peak WR were the main positively correlated influencing factors for FMS (p < 0.05), while Peak WR was a key factor affecting cf-PWV in relation to LDL-C (p < 0.05). The integrated remote comprehensive rehabilitation program established through 5G wearable real-time monitoring significantly enhanced the rehabilitation compliance and exercise endurance of PCI patients. FMS and cf-PWV can intuitively reflect the vascular improvement effects brought about by multidimensional interventions and serve as core indicators for assessing the recovery of vascular injury after PCI. Although literature supports that 5G may confer benefits through the shear stress-eNOS-NO and ox-LDL-MMP pathways, this study did not measure the relevant biomarkers; thus, this mechanism remains hypothetical and requires validation in future research.

PMID:42634872 | DOI:10.1096/fj.202602684RR

Categories
Nevin Manimala Statistics

The Mediating Role of Social Sensitivity in the Relationship Between Mindfulness and Secondary Traumatic Stress Among Social Media Users

Psychol Rep. 2026 Aug 24:332941261484082. doi: 10.1177/00332941261484082. Online ahead of print.

ABSTRACT

Exposure to traumatic events such as disasters, violence, and wars through social media has been associated with psychological distress and secondary traumatic stress (STS). However, limited evidence exists regarding how mindfulness and social sensitivity are associated with this digital form of trauma. This study examined the relationships among mindfulness, social sensitivity, and STS among social media users and tested the mediating role of social sensitivity. A descriptive, cross-sectional study was conducted in April 2025 with 433 social media users in Türkiye. Data were collected using the Secondary Traumatic Stress Scale for Social Media Users (STSS-SM), the Social Sensitivity Scale (SSS), and the Mindful Attention Awareness Scale (MAAS). Correlation and mediation analyses were performed using PROCESS Model 4. There was a weak but statistically significant negative correlation between STSS-SM scores and both SSS and MAAS scores (p < .001). Mediation analysis indicated that social sensitivity showed a statistically significant indirect association in the relationship between mindfulness and STS (p < .001). Participants reporting longer daily social media use had higher STS and lower mindfulness and social sensitivity levels. Higher mindfulness and social sensitivity were associated with lower levels of social media-related STS. Mindfulness-based psychoeducational interventions may represent promising approaches for supporting psychological well-being in digital environments.

PMID:42634855 | DOI:10.1177/00332941261484082

Categories
Nevin Manimala Statistics

EXPRESS: Higher order affordances for serve reception in volleyball

Q J Exp Psychol (Hove). 2026 Aug 24:17470218261484734. doi: 10.1177/17470218261484734. Online ahead of print.

ABSTRACT

Using a head-mounted virtual reality system, we investigated the ability of skilled volleyball players to perceive virtual volleyball serves, and to use such information to control their actions in receiving serves. We compared shorter and taller groups of competitive players, and we varied the height of incoming serves. In two experiments, we found that, with very rare exceptions, participants used either an overhead or underhand technique to receive serves. Technique selection was reliably related to serve height, such that the overhead technique was used for higher serves and the underhand technique for lower serves. In Experiment 1, participants were free to move in any way they wished in receiving serves. We found that participants tended to step backward prior to receiving higher serves, such that there was a statistically significant relation between the serve height, the magnitude of backward stepping, and the likelihood of the overhead technique. In Experiment 2, participants were not permitted to step in any direction. Here, we found that participants tended to jump prior to receiving higher serves, such that there was a statistically significant relation between serve height, jump height, and the likelihood of the overhead technique. We argue that participants perceived higher order affordances for using anticipatory whole-body movements to optimize the two serve reception techniques. We interpret our results as an extension of the concept of affordance-based control.

PMID:42634854 | DOI:10.1177/17470218261484734

Categories
Nevin Manimala Statistics

Multi-fidelity Monte Carlo fusion for BNCT dose calculation using a dual-branch network

Med Phys. 2026 Sep;53(9):e70646. doi: 10.1002/mp.70646.

ABSTRACT

BACKGROUND: Boron neutron capture therapy (BNCT) is a binary radiotherapy that selectively kills tumor cells. Its clinical implementation relies on Monte Carlo (MC)-based treatment planning systems, which are time-consuming and limit clinical workflow efficiency.

PURPOSE: To address this limitation, we propose a Multi-Fidelity MC-based Dual-Branch Network (MFMC-DBN) that leverages complementary information from low- and high-fidelity MC simulations through dual-branch feature fusion, enabling accurate and efficient BNCT dose calculation.

METHODS: The model was trained, validated, and tested using clinical data from 112 glioblastoma patients. Low-statistics coarse and fine mesh MC dose distributions (6.5×106 particle histories) and patient CT information were used to predict three-dimensional dose distributions. Performance was compared with an MC denoising method and a conventional neural network (NN) approach.

RESULTS: MFMC-DBN outperformed both the NN and MC denoising methods across evaluated metrics. It achieved a mean absolute percentage error (MAPE) of 1.98% in the gross tumor volume (GTV). Organ-specific MAPEs ranged from 1.1% to 3.9%, with a maximum mean absolute error (MAE) of0.28 Gy (RBE). Gamma analysis further showed high spatial agreement, with passing rates of 99.8% within the patient contour and 99.3% in the GTV under the 3%/3 mm criterion. The proposed method maintained high dosimetric accuracy while substantially accelerating BNCT dose calculation.

CONCLUSIONS: MFMC-DBN effectively integrates multi-fidelity MC information through a dual-branch attention mechanism, enabling rapid and accurate 3D BNCT dose prediction. By significantly reducing computation time compared with full MC simulations while preserving dosimetric fidelity, these results support the feasibility of the proposed framework for accelerated BNCT dose calculation under a fixed beam configuration.

PMID:42634850 | DOI:10.1002/mp.70646

Categories
Nevin Manimala Statistics

SMOKING, ENVIRONMENTAL EXPOSURES, AND CHRONIC LUNG DISEASE AS KEY RISK FACTORS FOR LUNG CANCER IN NORTH SUMATRA

Exp Oncol. 2026 Aug 21;48(2):152-160. doi: 10.15407/exp-oncology.2026.02.152.

ABSTRACT

BACKGROUND: Lung cancer remains the leading cause of cancer mortality worldwide, with increasing incidence in many developing countries. Understanding region-specific risk factors is essential for effective prevention strategies. This study aimed to identify major determinants of lung cancer in North Sumatra, Indonesia.

MATERIALS AND METHODS: A hospital-based observational study with a case-control analytical approach was conducted between August and November 2024 in three referral hospitals in North Sumatra. A total of 240 patients with histologically confirmed lung cancer and 240 controls without malignancy or chronic respiratory disease were included. Participants were comparable by sex and residential area, while age differences between groups were statistically adjusted in the multivariate regression model.

RESULTS: Smoking exposure differed significantly between cases and controls (p = 0.023). The multivariate analysis identified several independent predictors of lung cancer. Age <45 years increased the risk more than two-fold (OR 2.62; 95% CI 1.10-6.21), whereas age >65 years showed a lower relative risk (OR 0.54; 95% CI 0.33-0.88). The occupational exposure signicantly increased lung cancer risk (OR 1.91; 95% CI 1.13-3.25). Unhealthy indoor environments, characterized by poor ventilation and household pollutant exposure, were also associated with an increased risk (OR 2.53; 95% CI 1.45-4.40). Chronic respiratory diseases, particularly tuberculosis and chronic obstructive pulmonary disease, were more prevalent among cases and contributed to the elevated risk.

CONCLUSIONS: Smoking exposure, occupational hazards, unhealthy indoor environments, and chronic pulmonary diseases are important determinants of lung cancer in North Sumatra. Public health strategies focusing on tobacco control, improved workplace safety, and reduction of indoor air pollution may substantially reduce lung cancer burden in this region.

PMID:42634841 | DOI:10.15407/exp-oncology.2026.02.152

Categories
Nevin Manimala Statistics

Long-term evaluation of a zoned catch-neuter-vaccinate-release program integrating owner engagement and buffer zone strategies for humane dog population management and rabies control in Anuradhapura, Sri Lanka

Vet World. 2026 Jul 31;19(7):2816-2849. doi: 10.14202/vetworld.2026.2816-2849. Epub 2026 Jul 10.

ABSTRACT

BACKGROUND AND AIM: Catch-neuter-vaccinate-release (CNVR) is recognized as a humane and sustainable strategy for controlling free-roaming dog populations and eliminating dog-mediated rabies. However, long-term evaluations incorporating spatial planning and community participation remain scarce. This study assessed a five-year zoned CNVR program integrating owner engagement and a peripheral buffer zone strategy in Anuradhapura, Sri Lanka, a religious heritage city affected by frequent puppy dumping and high densities of free-roaming dogs.

MATERIALS AND METHODS: From 2021 to 2025, sexually intact free-roaming dogs were captured along predefined routes with standardized effort, while owned dogs were voluntarily presented to clinics. The municipality was divided into three zones according to anthropogenic characteristics, and a surrounding buffer zone was progressively intensified. Population trends were analyzed using negative binomial regression models. A questionnaire survey conducted in 2025 evaluated anti-rabies vaccination (ARV) and sterilization coverage among owned dogs. Spatial and household-level factors influencing coverage were examined using generalized linear mixed models.

RESULTS: The number of free-roaming dogs requiring sterilization declined from 1,368 in 2021 to 484 in 2025. Although annual declines in community dog counts per unit effort were not statistically significant, buffer zone interventions produced significant sex- and zone-specific effects, reducing male populations in zone 1 and female populations in zone 3. Owned dog numbers increased by 14.7% annually, primarily because female ownership increased by 24.1%. More than 78% of adult female dogs were sterilized. Questionnaire responses from 1,123 participants showed that 94.2% and 83.1% of owned dogs within and outside the municipality, respectively, had received at least one ARV, while annual vaccination coverage was 74.2% and 68.9%, respectively. Household-level analyses demonstrated that geographic location, rather than the number of dogs per household, explained most of the variation in vaccination and sterilization coverage, identifying several low-coverage locations that require targeted interventions.

CONCLUSION: A strategically zoned CNVR program incorporating owner participation and a boundary-sealing buffer zone effectively promoted humane management of the dog population and improved rabies control. Spatially targeted interventions and continued vaccination and sterilization campaigns are essential for achieving sustainable elimination of dog-mediated rabies in culturally complex urban environments.

PMID:42634835 | PMC:PMC13500148 | DOI:10.14202/vetworld.2026.2816-2849

Categories
Nevin Manimala Statistics

Comparative Efficacy of Er,Cr:YSGG Laser, Electrolytic Cleaning, and Chlorhexidine for the Decontamination of Sandblasted, Large-Grit, Acid-Etched (SLA) Implant Surfaces: An In Vitro Controlled Study

Cureus. 2026 Jul 24;18(7):e113294. doi: 10.7759/cureus.113294. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Predictable decontamination of exposed implant surfaces remains difficult to achieve in peri-implantitis therapy. Rough sandblasted, large-grit, acid-etched (SLA) surfaces and implant thread geometry may promote biofilm retention and limit the effectiveness of chemical antiseptics and mechanical instrumentation.

OBJECTIVE: This controlled in vitro study compared the antimicrobial efficacy of three clinically relevant decontamination approaches: 0.12% chlorhexidine (CHX), GalvoSurge electrolytic cleaning, and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation against Staphylococcus aureus biofilms formed on Straumann SLA tissue-level implants in a standardized peri-implant defect model.

METHODS: Forty-eight Straumann SLA tissue-level implants were fixed in custom three-dimensional (3D)-printed peri-implant defect models and individually contaminated with Staphylococcus aureus and incubated in brain-heart infusion broth for 72 hours at 37°C. Implants were randomly assigned to four groups (n = 12/group): untreated control, CHX immersion for 60 s, GalvoSurge electrolytic cleaning for 120 s, or Er,Cr:YSGG laser treatment (2780 nm; 2.5 W; 30 Hz; 70% water; 60% air; 30 s). Residual viable bacteria were recovered using a standardized microbrush protocol and expressed as log10(colony-forming units (CFU)/implant).

RESULTS: Mean log10(CFU/implant) values were highest in the untreated control group (5.09 ± 0.33), followed by CHX (4.03 ± 0.12), GalvoSurge (3.77 ± 0.25), and Er,Cr:YSGG laser treatment (2.52 ± 0.39). The corresponding reductions relative to control were approximately 1.06 log10 for CHX, 1.32 log10 for GalvoSurge, and 2.57 log10 for laser treatment. Statistical analysis demonstrated a significant treatment effect (p < 0.001), with laser irradiation achieving the greatest reduction in viable bacterial counts under the tested conditions.

CONCLUSION: All active protocols reduced viable Staphylococcus aureus counts compared with untreated implants. Within the limitations of this single-species in vitro model, Er,Cr:YSGG laser irradiation achieved the greatest reduction, whereas GalvoSurge and CHX resulted in moderate and comparable decreases. Further studies incorporating multispecies biofilms, assessment of implant surface integrity, and clinically relevant outcomes are warranted.

PMID:42634830 | PMC:PMC13500086 | DOI:10.7759/cureus.113294

Categories
Nevin Manimala Statistics

Protective efficacy of concomitant day-old vaccination with live-attenuated infectious bronchitis virus (IBV) vaccines (1/96 and H120 + PHY.LMV.42) against a Thai QX-like IBV challenge in commercial broilers

Vet World. 2026 Jul 31;19(7):3256-3267. doi: 10.14202/vetworld.2026.3256-3267. Epub 2026 Jul 28.

ABSTRACT

BACKGROUND AND AIM: Infectious bronchitis virus (IBV) remains a major cause of respiratory disease and economic loss in commercial poultry production, particularly with the emergence and widespread circulation of QX-like variants. In Thailand, these strains continue to challenge existing vaccination programs because of their genetic diversity and limited cross-protection afforded by conventional vaccines. This study evaluated the protective efficacy of concomitant day-old administration of two live-attenuated IBV vaccines (1/96 and H120 + PHY.LMV.42) against challenge with a Thai QX-like IBV strain in commercial broiler chickens.

MATERIALS AND METHODS: Seventy day-old Cobb500 broiler chickens were randomly assigned to vaccinated, positive control, and negative control groups. Birds in the vaccinated group received concomitant ocular administration of the 1/96 and H120 + PHY.LMV.42 vaccines at hatch and were challenged at 21 days of age with a Thai QX-like IBV strain (10⁴ median embryo infectious dose [EID₅₀]/0.1 mL). Protective efficacy was evaluated using tracheal ciliostasis protection score (CPS), binomial protection score (BPS), reverse transcription-polymerase chain reaction for viral detection, serological responses determined by enzyme-linked immunosorbent assay, and body weight measurements. Statistical analyses were performed using one-way analysis of variance or the Kruskal-Wallis test, with p < 0.05 considered statistically significant.

RESULTS: Vaccinated broilers exhibited significantly improved tracheal protection compared with unvaccinated challenged controls, achieving a CPS of 58.5% and a BPS of 100%, whereas positive control birds demonstrated complete ciliostasis (CPS = 0%). Viral detection was reduced in vaccinated birds, although the reduction was not statistically significant. Vaccinated birds also developed significantly higher antibody titers after challenge than negative controls (p < 0.05), indicating enhanced humoral immunity. Body weight at 26 days of age remained significantly lower in both challenged groups than in unchallenged controls, suggesting that vaccination only partially mitigated the adverse effects of IBV infection on growth performance. No mortality occurred during the experimental period.

CONCLUSION: Concomitant day-old administration of the 1/96 and H120 + PHY.LMV.42 live-attenuated vaccines provided measurable cross-protection against a Thai QX-like IBV challenge by preserving tracheal ciliary function, enhancing antibody responses, and reducing viral detection in commercial broilers. This hatchery-applicable vaccination strategy represents a practical approach for improving early protection against circulating QX-like IBV strains in Thailand. Nevertheless, protection remained partial, and additional studies involving larger populations, diverse circulating variants, quantitative viral load assessment, and commercial field validation are required to optimize vaccination strategies and confirm long-term protective efficacy.

PMID:42634820 | PMC:PMC13500146 | DOI:10.14202/vetworld.2026.3256-3267