Nevin Manimala

Support Care Cancer. 2026 Apr 17;34(5):441. doi: 10.1007/s00520-026-10666-2.

ABSTRACT

PURPOSE: The study explored the implementation of integrative nursing (IN) interventions in oncology inpatient care within a dedicated project. As part of an IN consultation service, trained integrative nurses delivered external naturopathic, non-pharmacological interventions. The aim of this study was to characterize patients receiving IN interventions and to describe how these interventions are implemented and applied in oncological inpatient care.

METHODS: This retrospective study analyzed routine project-related data collected at Ulm University Hospital between 2021 and 2023. Recorded variables included patient demographics, clinical characteristics, type and frequency of IN interventions, and immediate patient reaction. Quantitative data were analyzed descriptively, and qualitative data were examined using content analysis.

RESULTS: Healthcare professionals requested an IN consultation for 381 patients, of whom 361 (94.8%) agreed to participate. The majority were female (62.3%; n = 225) and between 60 and 69 years of age (33.5%; n = 121). In total, 1910 IN interventions were carried out, with a median of four IN interventions per patient (M = 5.3 ± 4.6; r = 1-30). Most IN interventions targeted the lower limbs (38.7%; n = 740), most frequently using rhythmic embrocation (70.9%; n = 1355) and solum oil (39.6%; n = 757). Immediately after the IN intervention, the most commonly observed patient reactions were relaxation (67.5%; n = 726) and deeper breathing (37.5%; n = 403).

CONCLUSION: The high level of acceptance and the continuous increase in utilization suggest that IN was well implemented in clinical practice during the project, with positive short-term reactions from patients. Further intervention studies are needed to provide robust evidence of its efficacy and to support its long-term integration into routine hospital care.

PMID:41998445 | DOI:10.1007/s00520-026-10666-2

Eur Radiol. 2026 Apr 17. doi: 10.1007/s00330-026-12544-1. Online ahead of print.

NO ABSTRACT

PMID:41998355 | DOI:10.1007/s00330-026-12544-1

Int Urogynecol J. 2026 Apr 17. doi: 10.1007/s00192-026-06660-1. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: High-quality patient education materials are essential in urogynecology. We hypothesized that patient handouts generated by different large language models (LLMs) would vary in quality and readability and would differ from an established society-produced leaflet.

METHODS: Twelve leaflets on bladder training and pelvic floor muscle therapy from six origins: GPT-4, Gemini-2.5 Pro, Sonnet-4, Llama-4, Perplexity, and The International Urogynecological Association (IUGA), were produced or obtained and standardized into plain text. Three blinded reviewers assessed completeness, information quality (DISCERN), and the Patient Education Materials Assessment Tool (PEMAT-A: actionability; PEMAT-U: understandability). The statistical plan included ordinary least squares fixed-effects per metric with type II analysis of variance for source effects; estimated marginal means with Holm-adjusted pairwise comparisons; a crossed mixed-effects model for topic groups; and inter-rater reliability was measured. Readability and text analyses used standard indices.

RESULTS: Origins varied in completeness (p < 0.001), DISCERN (p < 0.001), and PEMAT-A (p = 0.0018); PEMAT-U showed a trend (p = 0.063). Llama-4 scored significantly lower on completeness and DISCERN, and lower than GPT-4, IUGA, and Perplexity on PEMAT-A; Sonnet4 outperformed Llama-4 on PEMAT-U. No single origin dominated all metrics. Readability varied greatly: GPT-4 had an average Flesch-Kincaid grade level ≈ 6.6, Gemini ≈ 7.4; Sonnet4 ≈ 15; Llama-4 ≈ 17. IUGA leaflets were the longest, with grade levels around 9-10. Bladder-training materials were modestly more complete than pelvic muscle materials (p = 0.045). Inter-rater reliability was high (ICC ≥ 0.87).

CONCLUSIONS: Patient education quality varies substantially across AI tools and compared with society materials. AI-generated content can meet readability targets but requires expert review to ensure completeness and reliability before clinical use.

PMID:41998329 | DOI:10.1007/s00192-026-06660-1

Behav Res Methods. 2026 Apr 17;58(5):126. doi: 10.3758/s13428-026-02998-y.

ABSTRACT

Deficits in spatial and navigation abilities are among the earliest signs of dementia. Yet, traditional neuropsychological tests primarily target memory and attention. The Spatial Performance Assessment for Cognitive Evaluation (SPACE) is a novel gamified digital assessment for iPads that uses various spatial tasks to detect early deficits in spatial navigation abilities indicative of cognitive impairment. In this study, 348 participants aged 21-76 completed the Montreal Cognitive Assessment (MoCA), SPACE, and a sociodemographic and health questionnaire. We investigated whether SPACE could predict scores on the MoCA beyond known risk factors for cognitive impairment. Using a factor analysis, we then assessed whether SPACE could complement the MoCA by capturing latent variables independent of MoCA scores that represent additional spatial aspects of cognitive functioning. Results from a hierarchical regression revealed that the pointing and perspective-taking tasks in SPACE significantly predicted MoCA scores beyond age and gender. Surprisingly, none of the risk factors predicted MoCA scores. The factor analysis revealed that the MoCA and perspective-taking contributed to a separate factor from the other navigation tasks in SPACE. We also provide normative data on age and gender for each task in SPACE, which can serve as benchmarks for future studies to identify individuals at risk.

PMID:41998313 | DOI:10.3758/s13428-026-02998-y

J Gen Intern Med. 2026 Apr 17. doi: 10.1007/s11606-026-10444-0. Online ahead of print.

ABSTRACT

IMPORTANCE: Health care workers (HCWs), particularly those identifying as female or Black, face disproportionate mental health strain. Digital mental health platforms have grown in popularity and, for health systems, may offer scalable solutions, but their differential impact across demographic groups remains understudied.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of a randomized controlled trial enrolled 1275 HCWs from an urban academic health system between January and May 2022. Participants were randomized to usual care or proactive digital engagement via the Cobalt platform. Female and Black HCWs were oversampled to assess subgroup effects.

INTERVENTION: Monthly digital outreach, including mental health symptom screening and linkage to resources via the Cobalt platform, compared with usual care.

MAIN OUTCOMES AND MEASURES: Primary outcomes were changes in depression (PHQ-9) and anxiety (GAD-7) scores at 6 and 9 months. Secondary outcomes included well-being (WHO-5, WBI-9) and work productivity (LEAPS). Generalized linear models assessed HTE by gender and race.

RESULTS: Of 1275 randomized participants (mean age 38.6 years; 83.4% female; 25.1% Black), both intervention and control groups showed significant reductions in anxiety and depression scores over time. No significant HTE was observed by gender or race for primary outcomes. Female HCWs receiving the intervention reported significantly greater improvement in work productivity at 6 months (LEAPS score difference: 1.70; p = 0.03). Black HCWs in the intervention arm showed a sustained improvement in depression scores at 9 months (- 2.21; p < 0.001), though adjusted models did not confirm statistical significance.

CONCLUSIONS AND RELEVANCE: A proactive digital mental health strategy coupled with a well-being platform improved mental health outcomes across HCWs, with modest differential effects in productivity and depression among female and Black participants. These findings support the scalability of digital interventions and highlight the need for culturally tailored approaches to enhance equity and impact.

PMID:41998267 | DOI:10.1007/s11606-026-10444-0

Aesthetic Plast Surg. 2026 Apr 17. doi: 10.1007/s00266-026-05851-x. Online ahead of print.

ABSTRACT

BACKGROUND: Several modalities have been developed to achieve precise tip contouring and address postsurgical edema. This comparative study aimed to analyze the short- and long-term effects of the Pitanguy ligament management on nasal tip aesthetics and postsurgical edema in open versus closed rhinoplasty.

METHODS: Patients were divided into three groups, each comprising 40 individuals. Group I (open rhinoplasty without ligament repair), Group II (open rhinoplasty with ligament repair), and Group III (closed rhinoplasty with ligament preservation). All patients included in the study were evaluated for the depth of the supratip area, nasal tip edema, rotations, projections and completed the Rhinoplasty Outcome Evaluation questionnaire.

RESULTS: The depth of the supratip area and tip edema were significantly different in group I than in groups II and III in early postoperative follow-ups (p<0.001). The Goode score and nasolabial angle were significantly different between groups I and III in the early postoperative period (p<0.05). However, there were no statistically significant differences in the depth of the supratip area, tip edema, and Goode score at 12 months postoperatively among the groups.

CONCLUSIONS: Precise control of the cartilaginous framework and soft-tissue covering combines the concepts that provide control of the projection, position, and rotation of the nasal tip in the long-term. Although subsiding initial edema and improved supratip definition were achieved in the early postoperative follow-up, there were no differences between the results of the surgeries in all groups in the long-term.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:41998167 | DOI:10.1007/s00266-026-05851-x

Sci Rep. 2026 Apr 18;16(1):12728. doi: 10.1038/s41598-026-45674-z.

ABSTRACT

The effect of different sequences of invitations to Faecal Occult Blood Test (FOBT) screening regarding colorectal cancer (CRC) incidence has never been evaluated. In 2008-2012, all residents in Stockholm-Gotland, Sweden, born 1938-1954, were randomly assigned by birth year to different calendar years of invitation to guaiac-based FOBT (g) or Faecal Immunochemical Test (f) screening at 60-69 years (1-5 rounds), or not (0). Linkage was made to the national Cancer- and Cause of Death Registers on CRC diagnosis and mortality 1958-2020, and the Swedish Colorectal Cancer Register regarding stage. Follow-up started age 60 and CRC incidence, calculated per 100,000 person-years, was assessed during screening (age 60-69) and post screening (age 70-73). Stage I-II and III-IV was assessed post screening. 364,668 individuals were included. During screening, incidence rate ratio was significantly higher in sequences (0, g, g, g, g) (RR 1.25, 95% CI 1.09-1.43), (g, g, g, g, f) (RR 1.17, 95% CI 1.01-1.35), and (g, g, f, f, f) (RR 1.14, 95% CI 1.01-1.29). Post screening, the largest decrease was seen in sequences (g, g, g, g, f) and (g, g, g, f, f), RR 0.65, 95%, CI 0.47-0.90, and RR 0.53, 95% CI 0.30-0.94, respectively. There was an overall decreasing trend along sequences from (0, 0, 0, 0, g) to (g, g, f, f, f) post screening and both stages I-II and III-IV (p < 0.001). We could demonstrate a decreased CRC incidence post screening proportional to the number of invitations with implications for future modeling studies and risk-based screening strategies.

PMID:41998115 | DOI:10.1038/s41598-026-45674-z

Eur J Oncol Nurs. 2026 Apr 9;82:103189. doi: 10.1016/j.ejon.2026.103189. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigates the associations between anticipatory grief and dyadic coping among advanced cancer patients and their spouses, aiming to provide empirical evidence for the development of family-centered dyadic interventions.

METHODS: A total of 230 dyads, consisting of advanced cancer patients and their spouses, were enrolled via convenience sampling from three hospitals in Guangdong Province between June and September 2025. Data acquisition was conducted utilizing a sociodemographic questionnaire, the Dyadic Coping Inventory (DCI), and the Anticipatory Grief Scale (AGS) tailored for patients and spouses. Subsequently, the Actor-Partner Interdependence Model (APIM) was constructed to analyze dyadic interactions, with all statistical estimations performed using Mplus software (version 8.3).

RESULTS: Based on the results of the Actor-Partner Interdependence Model (APIM), significant actor effects were identified, wherein higher levels of anticipatory grief were found to be negatively associated with individual dyadic coping for both patients and spouses (P < 0.001). Furthermore, significant partner effects were established; specifically, patients’ dyadic coping was negatively linked to spousal anticipatory grief, and spousal dyadic coping was similarly associated with patients’ anticipatory grief (P < 0.001).

CONCLUSION: An interdependent association is identified between the levels of anticipatory grief and dyadic coping patterns within advanced cancer patient-spouse dyads. Accordingly, the implementation of comprehensive assessments and the formulation of collaborative intervention strategies are advocated for the optimization of mental health and coping capacities for both members of the dyad.

PMID:41996769 | DOI:10.1016/j.ejon.2026.103189

J Med Internet Res. 2026 Apr 12. doi: 10.2196/78321. Online ahead of print.

ABSTRACT

BACKGROUND: Previous research has demonstrated that continuous glucose monitoring (CGM) use can improve glycemic control in people with type 2 diabetes when used regularly alongside an in-person digital diabetes self-management and education support (DSMES) program. However, to date there is limited evidence showing the benefits of a digitally-delivered DSMES program combined with real-time CGM for adults with type 2 diabetes.

OBJECTIVE: To evaluate the impact of a DSMES program coupled with CGM on hemoglobin A1c (HbA1c) and CGM-derived glycemic measures compared to usual care for adults with type 2 diabetes over 6 months.

METHODS: Participants with type 2 diabetes and HbA1c ≥8% (64 mmol/mol) not using mealtime bolus insulin (26-83 years old; mean HbA1c: 9.6% [81.2 mmol/mol]) were randomly assigned to a digital DSMES + CGM integrated solution (n=51) or usual care (n=49) for 6 months. The primary outcome was HbA1c. Secondary outcomes were CGM-derived glycemic measures, including glucose management indicator (GMI), percent time in range 70-180 mg/dL (TIR), above range (TAR; >180 mg/dL), and below range (TBR; <70 mg/dL), and mean glucose. Linear mixed effects models were used for intention-to-treat analyses.

RESULTS: HbA1c was lower among intervention versus usual care at 3 months (difference=-0.7% [-8.1 mmol/mol]; P=.03) and at 6 months (difference=-0.6% [-6.9 mmol/mol]; P=.12) but only reached statistical significance at 3 months. CGM-derived glycemic measures, including GMI (difference=-0.9%; P=.03), TIR (difference=14.6%; P=.04), and TAR (difference=-14.9%; P=.04), and mean glucose (difference=-36.4 mg/dL; P=.03) were also significantly improved for intervention vs usual care at 6 months.

CONCLUSIONS: The combination of digital DSMES + CGM is effective for supporting adults with type 2 diabetes in managing their condition and has potential to reduce the risk of long-term health complications.

CLINICALTRIAL: The trial was registered on ClinicalTrials.gov (NCT05368454).

PMID:41996671 | DOI:10.2196/78321

PLOS Glob Public Health. 2026 Apr 17;6(4):e0006316. doi: 10.1371/journal.pgph.0006316. eCollection 2026.

ABSTRACT

A proportion of global migration involves individuals migrating without parental or legal guardianship and those who face varied barriers to citizenship. Yet empirical evidence on their morbidity burdens and hospitalization particularly in Ghana and similar context remains scarce. This limits capacity for informed policy, planning, and response strategies aligned with global health targets. This study examined the burden of communicable and non-communicable diseases (NCDs), and predictors of hospitalization among these vulnerable groups. A cross-sectional survey was conducted from March 2024 to May 2024 among 481 purposively selected unaccompanied migrants and persons prone to statelessness in the Greater Kumasi Metropolitan Area and the Awutu Senya East Municipal Area. Data were analyzed using descriptive statistics (frequency, and percentages) and complementary log-log regression in Stata 14.2. Statistical significance was set at p ≤ 0.05. The analyses revealed a higher prevalence of communicable diseases (23.3%) than NCDs (8.1%). Malaria (90%), flu/cold (30%), typhoid (27%), diabetes (33%) and asthma (21%) emerged as common health conditions with limited and condition-specific subgroup differences. Overall, 8.7% of respondents reported ever being hospitalized. Across models, frequent illness (Model 1: OR = 4.097, 95% CI: 2.056-8.163; Model 2: OR = 3.724, 95% CI: 1.830-7.576; Model 3: OR = 4.224, 95% CI: 2.002-8.913; all p < 0.001) and diagnosis with an NCD (Model 1: OR = 3.336, 95% CI: 1.611-6.906; Model 2: OR = 3.600, 95% CI: 1.737-7.460; Model 3: OR = 3.873, 95% CI: 1.861-8.058; all p ≤ 0.001) were consistently associated with higher odds of hospitalization. These findings offer contextually bounded insights highlighting that health vulnerability among these populations is manifested less through differential disease prevalence but more through recurrent illness and NCD diagnosis necessitating hospitalization. This underscores the need for early detection, continuous care, and effective outpatient NCD management.

PMID:41996346 | DOI:10.1371/journal.pgph.0006316