Category: Nevin Manimala

N Z Med J. 2025 Mar 28;138(1612):60-70. doi: 10.26635/6965.6718.

ABSTRACT

Using data extracted from the New Zealand Health Survey (NZHS), the purpose of this study was to compare lesbian, gay and bisexual people and heterosexual people on engagement with general practitioner (GP) and nursing services and patient experiences of GP services. Quantitative data spanning four waves of NZHS from the years 2017/2018 to 2020/2021 were used to undertake a comparative analysis of lesbian females, bisexual females, gay males, bisexual males and heterosexual males and females. Statistically significant differences were observed in the percentage of GP and nurse utilisation across sexual identity groups. Our analysis showed that both bisexual females and gay/bisexual males were significantly more likely to report poorer levels of trust in GPs and experience poorer explanation of doctors and health conditions. The findings of this study indicate that lesbian, gay and bisexual people have a poorer experience of GP services than do their heterosexual counterparts. These findings indicate the need for GPs and nurses to better understand the ways in which the health needs of lesbian, gay and bisexual people differ from those of heterosexuals to facilitate the provision of culturally appropriate care.

PMID:40146957 | DOI:10.26635/6965.6718

N Z Med J. 2025 Mar 28;138(1612):21-46. doi: 10.26635/6965.6789.

ABSTRACT

AIM: The aim of this study is to understand patterns and experiences of smoking and electronic cigarette use, as well as related attitudes and behaviours among adults in Aotearoa New Zealand who smoke or recently stopped smoking.

METHODS: We analysed data from the Evidence for Achieving Smokefree Aotearoa Equitably/International Tobacco Control New Zealand Survey (N=1,230), conducted between November 2020 and February 2021.

RESULTS: Among people who smoked, 77.5% (95% confidence interval [CI] 74.0-80.8%) reported regretting having started smoking, 73.6% (95% CI 69.5-77.4) intended to quit, 87.3% (95% CI 84.1-89.9) reported being addicted to smoking and 86.3% (95% CI 83.3-88.8) had tried to quit smoking in the past. Among people who smoked, 24.8% (95% CI 21.3-28.6) used electronic cigarettes (ECs) daily and 4.6% (95% CI 3.3-6.6) used heated tobacco products (HTPs) daily. Among people who had recently stopped smoking, 33.4% (95% CI 25.6-42.2) used ECs daily and less than 1% used HTPs daily.

CONCLUSION: High levels of regret for starting smoking, addiction and intent to quit smoking highlight the importance of implementing effective and equitable smokefree measures to prevent people from starting to smoke and to support people to stop smoking.

PMID:40146955 | DOI:10.26635/6965.6789

N Z Med J. 2025 Mar 28;138(1612):13-20. doi: 10.26635/6965.6774.

ABSTRACT

AIM: The aim was to determine whether changes made to the Southern Cochlear Implant Programme (SCIP) following a previous audit in 20141 have affected referral patterns, and to identify ongoing areas of potential need that may inform future service provision and organisational policy. The primary objective was to assess whether changes in referral patterns (specifically distance to referral centre, ethnicity) occurred following interventions in SCIP service provision. The secondary objective was to evaluate the distribution of socio-economic deprivation for referrals to SCIP.

METHODS: A retrospective review of all adult patients referred for consideration of cochlear implantation to the SCIP was conducted between 1 December 2014 and 1 December 2022. Distances to nearest SCIP referral centre were calculated based on patients’ regions of domicile. This was modelled with linear regression to assess the relationship between incidence of referrals and distance to nearest SCIP centre. Along with demographic data, this was compared to the 2014 audit and baseline New Zealand population demographics from the 2018 New Zealand Census.

RESULTS: In total, 793 individual patient referrals were identified and included. An improvement in referrals relative to distance to SCIP centre was demonstrated, along with a more even distribution of referrals across socio-economic groups. Assessment of ethnicity data was limited by the amount of unrecorded data.

CONCLUSION: Publicly funded cochlear implantation is currently a limited resource in New Zealand. Findings from this audit help assess both current and past service provisions, providing insights to guide future service developments. Interventions targeted at improving access to SCIP for those more geographically isolated from the service appear to be effective. These interventions, along with ongoing collection, audit and reporting of demographic data including ethnicity, should continue and help inform future service planning.

PMID:40146954 | DOI:10.26635/6965.6774

Womens Health (Lond). 2025 Jan-Dec;21:17455057251326008. doi: 10.1177/17455057251326008. Epub 2025 Mar 27.

ABSTRACT

BACKGROUND: In the United States, Black women have the second highest incidence of cervical cancer (CC) due to high incidence of human papillomavirus (HPV), slow HPV clearance rates, and low receipt of preventive pap smears and vaccines.

OBJECTIVE: A Black Feminist Thought framework was used to examine how the media portrayal of Black women, racial identity, and familial factors impact CC prevention behaviors among young Black women.

DESIGN: Black women enrolled at a large southeastern university consented and participated in an online mixed-methods survey examining facilitators and barriers to CC prevention behaviors. Quantitative items were analyzed via descriptive statistics, and qualitative items were thematically evaluated using an interpretative phenomenological analysis.

METHOD: Black undergraduate women completed an online survey that collected quantitative data on demographic information, CC knowledge, perceived eHealth literacy, and CC prevention behaviors. Participants also responded to seven qualitative items that explored how the media portrayal of Black women, racial identity, and familial factors impact their CC prevention behaviors.

RESULTS: Participants (N = 146) were Black college women aged 18-26 who primarily identified as cisgender, non-Hispanic/Latine/x, and heterosexual. Most participants self-reported as having high e-Health literacy (78.1%, n = 114) but demonstrated inadequate CC knowledge (90.3%, n = 131). All age-eligible participants received pap smears within their lifetime (n = 6), and most received at least one dose of the HPV vaccine (77.5%, n = 86), with the majority reporting series completion. Qualitative findings highlighted participants experiences of oppression co-existed with self-advocacy, primarily in medical settings.

CONCLUSION: Results provide insight for culturally tailored interventions in care settings serving young Black women that may encourage preventive care to reduce the prevalence of CC in later adulthood.

PMID:40146936 | DOI:10.1177/17455057251326008

Eur J Dent Educ. 2025 Mar 27. doi: 10.1111/eje.13090. Online ahead of print.

ABSTRACT

BACKGROUND: Periodontal surgery is part of the dental curriculum at German universities. A particular challenge is to provide a basic understanding of surgery. This is the first pilot study evaluating the extent to which regenerative therapy or lower molar hemisection can be learned using a specially produced 3D-individualised patient model compared to a porcine cadaveric model.

METHODS: During the periodontal surgery block practical, 14 students performed lower molar hemisection and regenerative therapy with bone graft substitute (Bio Oss, Bio Gide; Geistlich Pharma AG, Wolhusen, Switzerland) on an individualised 3D model. Interventions were then evaluated using a validated questionnaire. Differences between groups were statistically assessed for individual items and the overall questionnaire using the Wilcoxon test (p < 0.05).

RESULTS: In the overall evaluation, the 3D-printed patient and animal cadaveric model did not differ significantly, with the animal cadaveric model scoring a slightly higher score. The 3D-printed patient model was considered more realistic for the anatomical appearance of each part, being evaluated superior for practicing regenerative therapy, removing inflammatory tissue and performing molar hemisections. The animal cadaveric model was rated better for soft and hard tissue tactile feedback.

CONCLUSION: With the 3D-individualised model, hemisection and regenerative therapy can be performed realistically, but soft and hard tissue feedback still needs to be optimised. 3D models are useful for teaching periodontal surgery. In the future, if optimised, 3D printing could completely replace the animal cadaveric model, as it offers clear advantages (e.g., easier organisation, better hygiene).

PMID:40146918 | DOI:10.1111/eje.13090

JMIR Med Inform. 2025 Mar 27;13:e67591. doi: 10.2196/67591.

ABSTRACT

BACKGROUND: Integrated clinical databases from national biobanks have advanced the capacity for disease research. Data quality and completeness filters are used when building clinical cohorts to address limitations of data missingness. However, these filters may unintentionally introduce systemic biases when they are correlated with race and ethnicity.

OBJECTIVE: In this study, we examined the race and ethnicity biases introduced by applying common filters to 4 clinical records databases. Specifically, we evaluated whether these filters introduce biases that disproportionately exclude minoritized groups.

METHODS: We applied 19 commonly used data filters to electronic health record datasets from 4 geographically varied locations comprising close to 12 million patients to understand how using these filters introduces sample bias along racial and ethnic groupings. These filters covered a range of information, including demographics, medication records, visit details, and observation periods. We observed the variation in sample drop-off between self-reported ethnic and racial groups for each site as we applied each filter individually.

RESULTS: Applying the observation period filter substantially reduced data availability across all races and ethnicities in all 4 datasets. However, among those examined, the availability of data in the white group remained consistently higher compared to other racial groups after applying each filter. Conversely, the Black or African American group was the most impacted by each filter on these 3 datasets: Cedars-Sinai dataset, UK Biobank, and Columbia University dataset. Among the 4 distinct datasets, only applying the filters to the All of Us dataset resulted in minimal deviation from the baseline, with most racial and ethnic groups following a similar pattern.

CONCLUSIONS: Our findings underscore the importance of using only necessary filters, as they might disproportionally affect data availability of minoritized racial and ethnic populations. Researchers must consider these unintentional biases when performing data-driven research and explore techniques to minimize the impact of these filters, such as probabilistic methods or adjusted cohort selection methods. Additionally, we recommend disclosing sample sizes for racial and ethnic groups both before and after data filters are applied to aid the reader in understanding the generalizability of the results. Future work should focus on exploring the effects of filters on downstream analyses.

PMID:40146917 | DOI:10.2196/67591

JMIR Serious Games. 2025 Mar 27;13:e54312. doi: 10.2196/54312.

ABSTRACT

BACKGROUND: The exponential growth of new technologies has resulted in the need for updating the field of education. From the educational point of view, there are some studies that have promoted the implementation of new technologies. These facts have raised the need to implement augmented reality in the university environment, especially among students of health sciences. The use of augmented reality can mean a new approach to teaching by teachers and better learning by students.

OBJECTIVE: We aimed to analyze the degree of usability of two augmented reality applications and to compare the academic performance between the control group and the experimental group at the Universities of Cádiz and Málaga. The students at the University of Málaga used the Zapworks augmented reality software, while those at the University of Cádiz used the Aumentaty augmented reality software for their respective experimental groups. The secondary objective was to measure the relationships between all the studied variables.

METHODS: This was a quasi-experimental design with a posttest as the only evaluation measure. We followed the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement and the ethical and legal aspects of the Principles of the Declaration of Helsinki. An intervention was carried out using two augmented reality applications on the subject of General Procedures in Physiotherapy II at the Universities of Málaga and Cádiz.

RESULTS: A total of 199 participants took part in the study. Demographic variables, ratings, and usability were assessed, followed by statistical analysis, with the results and their interpretation being described in the study. Significant differences (P<.001) were found in the ratings at both the universities. In addition, significant differences (P<.001) were found between the experimental group and the control group. Regarding the degree of usability in the univariate analysis, no significant differences were found (P=.049). A multiple regression analysis of the rating and usability was performed. The rating showed significant differences, with a beta of 1.4 (P<.001), and usability was also significant (P=.03) in favor of the Aumentaty group.

CONCLUSIONS: Significant differences were observed in those who used augmented reality compared to the control group, with higher values observed in the University of Cádiz. There are no correlations between the variables of usability and qualifications.

PMID:40146914 | DOI:10.2196/54312

J Eval Clin Pract. 2025 Mar;31(2):e70059. doi: 10.1111/jep.70059.

ABSTRACT

BACKGROUND: This study was conducted to determine the prevalence of breast milk and breastfeeding myths during pregnancy among Turkish, Turkish-Romani, and Syrian pregnant women and compare the similarities and differences between the countries.

METHODS AND STUDY DESIGN: The sample of the study consisted of 330 pregnant women who presented to a hospital. Data were collected with a ‘Descriptive Information Form’ and ‘Breast Milk and Breastfeeding Myths Form’ developed by the researchers. The Breast Milk and Breastfeeding Myths Form consists of items expressing common beliefs about breast milk and breastfeeding, and each item is evaluated with one of the following three options: ‘yes,’ ‘no,’ and ‘no idea.’ The forms were applied face to face to the pregnant women who came to the outpatient clinic. The data were evaluated on the SPSS (14.0) software package, and chi-square and advanced analyses were used for the statistical analysis.

RESULTS: Turkish, Turkish-Romani, and Syrian pregnant women who made up the study sample had similar socio-demographic characteristics. It was determined that there were intercultural differences in 28 out of 30 myths evaluated by Turkish, Turkish-Romani, and Syrian mothers regarding breast milk and breastfeeding.

CONCLUSION: It was determined that Turkish pregnant women had different myths about breast milk and breastfeeding from Syrian and Turkish-Romani pregnant women. It can be said that false beliefs and attitudes about breast milk and breastfeeding are common.

PMID:40146878 | DOI:10.1111/jep.70059

Proc Natl Acad Sci U S A. 2025 Apr;122(13):e2422968122. doi: 10.1073/pnas.2422968122. Epub 2025 Mar 27.

ABSTRACT

The origin of eukaryotes represents one of the most significant events in evolution since it allowed the posterior emergence of multicellular organisms. Yet, it remains unclear how existing regulatory mechanisms of gene activity were transformed to allow this increase in complexity. Here, we address this question by analyzing the length distribution of proteins and their corresponding genes for 6,519 species across the tree of life. We find a scale-invariant relationship between gene mean length and variance maintained across the entire evolutionary history. Using a simple model, we show that this scale-invariant relationship naturally originates through a simple multiplicative process of gene growth. During the first phase of this process, corresponding to prokaryotes, protein length follows gene growth. At the onset of the eukaryotic cell, however, mean protein length stabilizes around 500 amino acids. While genes continued growing at the same rate as before, this growth primarily involved noncoding sequences that complemented proteins in regulating gene activity. Our analysis indicates that this shift at the origin of the eukaryotic cell was due to an algorithmic phase transition equivalent to that of certain search algorithms triggered by the constraints in finding increasingly larger proteins.

PMID:40146859 | DOI:10.1073/pnas.2422968122

Science. 2025 Mar 28;387(6741):1391-1397. doi: 10.1126/science.adp4642. Epub 2025 Mar 27.

ABSTRACT

Describing the distribution of genetic variation across individuals is a fundamental goal of population genetics. We present a method that capitalizes on the rich genealogical information encoded in genomic tree sequences to infer the geographic locations of the shared ancestors of a sample of sequenced individuals. We used this method to infer the geographic history of genetic ancestry of a set of human genomes sampled from Europe, Asia, and Africa, accurately recovering major population movements on those continents. Our findings demonstrate the importance of defining the spatiotemporal context of genetic ancestry when describing human genetic variation and caution against the oversimplified interpretations of genetic data prevalent in contemporary discussions of race and ancestry.

PMID:40146820 | DOI:10.1126/science.adp4642