Nevin Manimala

Ther Apher Dial. 2025 Oct 30. doi: 10.1111/1744-9987.70092. Online ahead of print.

ABSTRACT

INTRODUCTION: This pioneering study aimed to examine the effects of virtual reality (VR)-based videos on symptoms, vital signs, and comfort levels in hemodialysis patients, offering an innovative approach to improving their quality of life.

METHODS: This randomized controlled pretest-posttest study included 54 hemodialysis patients treated at “X” Hospital between June 2024 and May 2025. Twenty-five patients were assigned to the intervention group, 25 to the control group, and 4 to a pilot group. Data were collected at baseline and after 8 weeks. Statistical analyses included t-tests, repeated measures ANOVA, Mann-Whitney U, and Friedman tests.

RESULTS: In the intervention group, Dialysis Symptom Index (DSI) scores decreased significantly (p < 0.05), and comfort levels increased significantly (p < 0.05) across all subscales of the Hemodialysis Comfort Scale Version II. Vital signs remained within normal ranges before and after the intervention.

CONCLUSION: This study revealed that the use of virtual reality headsets significantly influenced dialysis symptom index scores and comfort levels. The intervention effectively reduced dialysis symptoms and significantly increased patient comfort. No significant differences were observed in vital signs.

PMID:41164907 | DOI:10.1111/1744-9987.70092

Ann Hum Genet. 2025 Oct 30. doi: 10.1111/ahg.70029. Online ahead of print.

NO ABSTRACT

PMID:41164899 | DOI:10.1111/ahg.70029

Int J Dermatol. 2025 Oct 30. doi: 10.1111/ijd.70125. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between hidradenitis suppurativa (HS) and arthritis is well-established; however, the impact of their combined disease burden and the associated treatment pattern has not been determined yet. This study aimed to assess disease burden and therapeutic approaches in HS patients with and without arthritis and estimate arthritis prevalence and subtypes.

METHODS: A multicenter, retrospective, case-control study of 272 adults (69 with HS and arthritis; 203 with HS only), drawn from a hospital-based cohort of 3644 HS patients across 10 Spanish centers. Controls were matched 1:3 by sex, age, and HS duration. Statistical analysis included non-parametric tests, logistic regression, and linear mixed-effects models adjusted for confounders.

RESULTS: HS patients with arthritis had higher rates of immune-mediated diseases, including inflammatory bowel disease (odds ratio [OR] 9.44, p < 0.0001) and psoriasis (OR 2.99, p = 0.0038), higher Dermatology Life Quality Index (DLQI) scores (6.30 vs. 4.03, p = 0.031), more dermatology visits (7.00 vs. 5.00, p = 0.0077), and greater biologic therapy use (72.07% vs. 39.90%, p < 0.0001). The prevalence of arthritis among HS patients was 1.70% (95% confidence interval [CI]: 1.00%-2.70%), with spondyloarthritis being the most common subtype (66.6%).

CONCLUSIONS: HS patients with arthritis have a greater disease burden and higher biologic therapy utilization, emphasizing the need for interdisciplinary care and optimizing resources.

PMID:41164894 | DOI:10.1111/ijd.70125

Zhonghua Yi Xue Za Zhi. 2025 Oct 30;105:3650-3656. doi: 10.3760/cma.j.cn112137-20250826-02191. Online ahead of print.

ABSTRACT

Objective: To explore the accuracy and comprehensiveness of responses from four large language models [ChatGPT-3.5 (Model A), ChatGPT-4.0 (Model B), ChatGPT-4o (Model D) developed by OpenAI in the United States, and a domestically developed Obstetric artificial intelligence assistant robot (Model C)] to inquiries from patients with placenta accreta spectrum disorders and their families. Methods: A prospective study was conducted from June 2024 to March 2025, involving 25 pairs of patients and their families and 8 obstetric experts at the Third Affiliated Hospital of Guangzhou Medical University. Sixteen questions commonly asked by patients and their families regarding placenta accreta spectrum disorders were collected, covering six disease-related areas such as disease mechanism, risk factors, clinical symptoms, diagnosis, pregnancy management, and prognosis. A physician then input all the questions into the four different large language models to obtain their responses. The responses were randomized and independently evaluated by four maternal-fetal medicine physicians using a three-point Likert scale and a six-point Likert scale to assess the accuracy of the responses. The majority consensus method was used to determine the final rating for each model’s response. For responses rated as “good” and scored 5 or above on the six-point Likert scale, a three-point Likert scale was further used to assess the comprehensiveness of the content. The accuracy and comprehensiveness of the 4 large language models was compared. Results: Significant differences in accuracy were observed among the four large language models (P=0.005). 25% (4/16) of Model A responses were rated as “good”, which was lower than the 75% (12/16) for both Model B and Model D (both P<0.05). The comprehensiveness score for Model A was 1.8 (1.5, 2.0), for Model B was 2.0 (1.8, 2.0), for Model C was 2.3 (2.0, 2.3), and for Model D was 2.6 (2.3, 2.7). There were statistically significant differences in comprehensiveness scores among the four large language models (P<0.001). Pairwise comparisons showed that Model D was significantly more comprehensive than Model A (P=0.004) and Model B (P<0.001). Conclusions: Significant variations exist in both the accuracy and comprehensiveness of responses from the four large language models to questions in six areas related to placenta accreta spectrum disorders. Model D performs better in both aspects. Model C has a better performance in comprehensiveness, but its accuracy needs further improvement.

PMID:41164852 | DOI:10.3760/cma.j.cn112137-20250826-02191

Front Public Health. 2025 Oct 14;13:1659127. doi: 10.3389/fpubh.2025.1659127. eCollection 2025.

ABSTRACT

College and university faculty and staff in the United States experience diabetes rates higher than the national average, elevated cholesterol levels, receive fewer than the recommended 7 h of sleep per night, and routinely experience overwhelming anxiety. In response, some universities have implemented top-down approaches to employee wellness but there is scant evidence of student-driven approaches to faculty and staff wellness. The current study examines improvement in faculty and staff participation consistency when enrolled in a fully student-developed, -implemented, and -evaluated 8-week health and wellness program. The 78 participants in the study were asked to complete both a pre- and post-intervention Likert scale questionnaire, which was assessed by independent T-tests. There was a statistically significant difference in mean of the participation of staff in the wellness program activities within the university and at local community activities pre- and post-challenge (Mean difference: -0.456, 95% CI: -0.882 – -0.048; p = 0.029). In a similar vein, there was a statistically significant difference between pre-intervention and post-intervention participation in nutritional programs at the university and the surrounding local community by staff and faculty (Mean difference: -0.472, 95% CI: -0.817 – -0.127; p = 0.008). This increased participation could be the result of nudging used throughout the intervention, which included weekly consistency reporting reminders, weekly newsletters, regular email promotions, mailbox stuffers, and personal reminders to participate. It is our belief that this nudging approach led to habituation of participation amongst faculty and staff members.

PMID:41164848 | PMC:PMC12558935 | DOI:10.3389/fpubh.2025.1659127

Front Public Health. 2025 Oct 14;13:1683985. doi: 10.3389/fpubh.2025.1683985. eCollection 2025.

ABSTRACT

Syndemics involving Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) remain a major public health challenge in sub-Saharan Africa, and understanding their spatial and temporal dynamics is critical for effective interventions. Using data from two consecutive, population-based cross-sectional surveys conducted in 2014 and 2015 under the HIV Incidence Provincial Surveillance System (HIPSS) in KwaZulu-Natal, South Africa, we applied a Bayesian spatio-temporal framework grounded in latent variable modeling to quantify and map the syndemic burden of HIV and other STIs. A confirmatory factor analysis constructed a continuous latent syndemic score from four binary indicators (HIV diagnosis, HIV testing, STI diagnosis, and STI symptoms), which was modeled using Bayesian hierarchical spatial methods via Integrated Nested Laplace Approximation (INLA), incorporating spatial random effects through the Stochastic Partial Differential Equation (SPDE) approach and temporal effects via a first-order random walk. Local spatial autocorrelation, assessed using Local Moran’s I and Getis-Ord Gi^* statistics, revealed consistent hotspots and coldspots. Syndemic burden of HIV and other STIs was higher among younger adults (20-49 years), women, individuals with incomplete secondary education, those engaging in sexual risk behaviors or reporting forced sexual debut, and those facing socioeconomic vulnerabilities such as food insecurity. Access to healthcare and treatment for depression were also positively associated, likely reflecting increased detection. Local Moran’s I identified 11 significant clusters (three hotspots, eight coldspots), and Getis-Ord Gi^* identified 32 (17 hotspots, 15 coldspots), with hotspot patterns persisting across both years, indicating temporal stability. These findings highlight the utility of Bayesian latent variable and spatio-temporal modeling in integrating multiple co-occurring health conditions into a single spatial framework, providing actionable evidence to support geographically targeted, multi-sectoral interventions that address structural and behavioral drivers of co-epidemics in resource-limited settings.

PMID:41164847 | PMC:PMC12558856 | DOI:10.3389/fpubh.2025.1683985

Front Public Health. 2025 Oct 14;13:1650147. doi: 10.3389/fpubh.2025.1650147. eCollection 2025.

ABSTRACT

BACKGROUND: To analyze the equity of the current allocation of health human resources using statistical data on health resources in the Yangtze River Delta region.

METHODS: The Gini coefficient quantifies the level of distributional equality, the Theil index assesses the source of inequality, and the health resource agglomeration degree (HRAD) measures the accessibility of health resources, combining the three methods to evaluate the equity of the current allocation of health human resources in the Yangtze River Delta region. Furthermore, trend analysis of fairness indicators was conducted using regression models.

RESULTS: Human resources for health in the Yangtze River Delta region have been increasing between 2014 and 2022. The Gini coefficient and Theil index in the Yangtze River Delta region are more equitable in terms of the distribution of healthcare resources based on population and gross domestic product (GDP) rather than geographical region. In Anhui Province, HRAD and HRAD/PAD (population agglomeration degree) were both less than 1. In Zhejiang Province, HRAD for health technicians and registered nurses was less than 1.

CONCLUSION: Human resources for health and healthcare ratios in the Yangtze River Delta region have continued to grow. However, the equity of health resources allocated based on population and economic factors is superior to that allocated based on geographical factors, and the equity of health resource concentration remains to be improved. To address this equity issue, it is necessary to comprehensively consider various factors such as population, geography, and GDP, and formulate corresponding measures accordingly.

PMID:41164836 | PMC:PMC12558889 | DOI:10.3389/fpubh.2025.1650147

Front Public Health. 2025 Oct 14;13:1591186. doi: 10.3389/fpubh.2025.1591186. eCollection 2025.

ABSTRACT

The increasing efforts among public health researchers to examine the connections between police violence and health outcomes has resulted in growing discoveries about the implications for both direct and vicarious exposure as well as disparities by race and ethnicity. To date, the conceptualization of police violence and health has largely focused on single causes and/or mechanisms at one point in time and focused on individuals most proximal to impact. However, the prevailing conceptualizations are limited in scope. They are relatively linear, do not account for multiple dimensions of harm, and are void of temporal factors that span across communities and generations-all factors that are sustained by forms of structural racism. We offer a reconceptualization guided by the Public Health Critical Race Praxis (PHCRP), a public health offshoot of Critical Race Theory, that offers public health professionals a framework and semi-structured process for centering racism in their analyses and implications of police violence on health. Our conceptualization is supported by multiple case studies, and we conclude with concrete recommendations for public health professionals to draw on as strategies to address police violence and advance health equity.

PMID:41164835 | PMC:PMC12558832 | DOI:10.3389/fpubh.2025.1591186

Front Public Health. 2025 Oct 14;13:1615781. doi: 10.3389/fpubh.2025.1615781. eCollection 2025.

ABSTRACT

BACKGROUND: Evidence on frontline implementation of integrated HIV/TB prevention in resource-limited, ethnic minority regions remains limited. Liangshan Yi Autonomous Prefecture in Southwest China carries a dual HIV/TB burden. This study explored healthcare workers’ experiences with China’s Integrated Prevention and Control of Four Diseases (IPC4D) policy to identify barriers and enablers of service integration.

METHODS: A qualitative phenomenological study was conducted from July to December 2024. 37 semi-structured interviews were held with purposively sampled healthcare workers across prefectural CDCs, infectious disease hospitals, county hospitals, and township health centers. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed following Braun and Clarke’s six-phase framework. Reflexive memos and triangulation across facility levels, professional roles, and ethnic groups enhanced study rigor.

RESULTS: Four themes emerged. First, policy-driven progress: participants reported greater governmental support, increased resource inputs, and modest improvements in public awareness. Second, structural barriers: chronic underfunding of TB services, workforce shortages, and burnout weakened integration. Third, the multi-sectoral “1 + M + N + P” model-local government leadership (“1”), township centers (“M”), village doctors and maternal-child health staff (“N”), and public security departments (“P”)-expanded service reach but also generated task overload, cultural-linguistic challenges, and inter-sectoral friction. Fourth, urban-rural divergence: township providers faced more severe infrastructure gaps and patient non-adherence, often driven by stigma and financial constraints.

CONCLUSION: The IPC4D policy demonstrates potential to reduce HIV/TB disparities in Liangshan, yet sustained progress requires dedicated TB financing, culturally competent workforce training, rational task redistribution, and stigma-reduction strategies that leverage Yi community networks. These findings provide practical insights for adapting integrated disease-control policies in other high-burden, resource-constrained settings.

PMID:41164833 | PMC:PMC12558838 | DOI:10.3389/fpubh.2025.1615781

Front Public Health. 2025 Oct 14;13:1592366. doi: 10.3389/fpubh.2025.1592366. eCollection 2025.

ABSTRACT

OBJECTIVES: This study aimed to verify the hypothesis that the improvement in the subjective assessment of population health in certain European countries after the COVID-19 pandemic was driven by the mortality of the majority of vulnerable citizens with the worst health status.

METHODS: We extended the trend of the share of the oldest age group and compared it with the observed fraction, thereby identifying the “missing population.”

RESULTS: We observed a substantial deficit in the population of the oldest age group, especially in countries where people tend not to age well.

CONCLUSION: The temporary improvement in population health indicators, as measured by Healthy Life Years (HLY), during the pandemic in some countries was most likely an artifact resulting from the mortality of the majority of vulnerable individuals with poor health status. It is unlikely that this apparent improvement reflects healthier lifestyles or genuine gains in the efficiency or resilience of health systems during the pandemic. Therefore, the interpretation and use of HLY values from the COVID-19 period in Europe should be carefully reconsidered and further validated.

PMID:41164832 | PMC:PMC12558791 | DOI:10.3389/fpubh.2025.1592366