PLoS ONE最新文献

{"title":"Dietary variability and micronutrient status of individuals with Yaws infection in Ghana: A case-control study.","authors":"Abigail Agbanyo, Michael Ntiamoah Oppong, Ruth Dede Tuwor, Pius Takyi, Felix Wireko, Philemon Boasiako Antwi, Dzifa Kofi Ahiatrogah, Aloysius Dzigbordi Loglo, Bernadette Agbavor, Alex Owusu-Ofori, Richard Odame Phillips, Yaw Ampem Amoako","doi":"10.1371/journal.pone.0334628","DOIUrl":"10.1371/journal.pone.0334628","url":null,"abstract":"<p><strong>Background: </strong>Yaws is a neglected tropical skin disease mainly affecting children under 15 years. It is targeted for eradication by 2030 through Mass Drug Administration (MDA) of a single oral dose of azithromycin (30 mg/kg), which has achieved about a 95% cure rate. Despite this, the disease persists in endemic countries. Eradication requires addressing contributing factors, including the role of nutrition in yaws; yet this remains underexplored. This study assessed the nutritional status of individuals in yaws-endemic areas using a case-control design.</p><p><strong>Methods: </strong>A case-control study was conducted from May to November 2024 in 33 communities across two districts in Ghana. Cases were Dual Path Platform (DPP) positive individuals, matched by age and sex with healthy controls. Data collection included demographic and anthropometric measurements and a Ghana-specific multi-pass 24-hour dietary recall.</p><p><strong>Results: </strong>A total of 64 cases and 64 matched controls [median age 11.5 years, Interquartile range (IQR) 9-13.8] were enrolled. Moderate stunting was found in 27% of cases and 22% of controls; severe stunting in 6% and 5%, respectively. Roots and tubers were consumed by all participants, while fruit intake was low (5% overall; 3% in cases, 8% in controls). Controls generally had slightly higher micronutrient intake than cases, except for energy (1754 ± 657 kcal vs. 1726 ± 707.3 kcal), fat (55.15 ± 28.04 g vs. 51.83 ± 27.04 g), and vitamin C (108.7 ± 42.24 mg vs. 107.7 ± 53.18 mg). No statistically significant differences in nutrient adequacy were found between healed and non-healed yaws cases (p > 0.05), though participants with non-healed lesions more often had inadequate intakes of energy (88% vs. 80%), fibre (100% vs. 96%), iron (63% vs. 54%), zinc (75% vs. 71%), and vitamin B12 (63% vs. 55%).</p><p><strong>Conclusion: </strong>In these yaws-endemic districts, we observed high levels of undernutrition and micronutrient deficiencies among both cases and controls. Although nutritional status was not independently linked to poorer treatment outcomes, the burden of malnutrition underscores the need for integrated health interventions. Further research is warranted to clarify the relationship between chronic nutritional deficiencies and yaws outcomes.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0334628"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different physical therapy training protocols on patients with idiopathic scoliosis: Short-term results.","authors":"Haohan Lu, Min Li, Naizhen Wang, Guobiao Ye, Feilong Zhu, Mingling Guo, Cheng Zeng","doi":"10.1371/journal.pone.0334713","DOIUrl":"10.1371/journal.pone.0334713","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic scoliosis (IS), a three-dimensional spinal deformity common in adolescents, can be treated with numerous approaches, including Schroth, Spiral stabilization (SPS), and core exercises, to improve spinal alignment and health. However, few studies have shown the superiority of one treatment over another.</p><p><strong>Objective: </strong>This retrospective cohort study was designed to evaluate the efficacy of three distinct physical therapy protocols in managing IS among adolescents aged 6-18 years with Cobb angles ≤40°.</p><p><strong>Methods: </strong>A total of 61 patients were allocated to one of three therapeutic groups. Each group received interventions twice weekly for 10 sessions. Primary outcomes were assessed by measuring changes in the Cobb angle, whereas secondary outcomes included evaluations of pain (visual analog scale, VAS), the angle of trunk rotation (ATR), trunk aesthetic clinical evaluation (TRACE), radiographic parameters (Alignment of the C7 plumbline (C7PL), clavicle angle, and pelvic obliquity), and quality of life (the Scoliosis Research Society-22 questionnaire,SRS-22).</p><p><strong>Results: </strong>The findings revealed significant within-group improvements in the Cobb angle, pain, and trunk rotation for all interventions (p < 0.05). Notably, between-group comparisons indicated that both the Schroth and SPS modalities resulted in greater reductions in the Cobb angle and trunk rotation than core stabilization exercises did (p < 0.05). Moreover, SPS resulted in superior enhancements in the clavicle angle and dynamic postural control, whereas Schroth yielded significant improvements in C7PL alignment.</p><p><strong>Conclusion: </strong>This short-term study underscores the relative effectiveness of the Schroth and SPS interventions in managing three-dimensional spinal deformities and enhancing dynamic postural control while recognizing the limitations of core stabilization exercises for scoliosis.</p><p><strong>Clinical trial registration: </strong>This retrospective analysis of a clinical trial has been registered in the Chinese Clinical Trial Registry (ChiCTR2500096077) https://www.google.com/search?client=firefox-b-d&q=ChiCTR2500096077.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0334713"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of drug-related problems among breast cancer patients in a cancer specialty center in Nepal.","authors":"Aman Kumar Sah, Roshan Prajapati, Nabin Pathak, Sushil Panta, Shila Gurung","doi":"10.1371/journal.pone.0334703","DOIUrl":"10.1371/journal.pone.0334703","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the leading cancer among women globally, and its management typically involves surgery, radiotherapy, and chemotherapy. This combination of complex treatment increases the risk of drug-related problems (DRPs), which can negatively impact the quality of life as it prolongs the hospital stays, increases healthcare costs, and leads to morbidity and mortality. Research on DRPs in the context of breast cancer patients in Nepal is limited; therefore, this study aimed to identify DRPs, assess their prevalence, and examine their associated factors, while emphasizing the importance of pharmaceutical care.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Bhaktapur Cancer Hospital, Nepal, from February to May 2024. The medical records of 92 patients were reviewed to identify DRPs using the Pharmaceutical Care Network Europe V9.1 tool, along with related scientific literatures and evidence-based guidelines, and verified by two independent medical oncologists. Descriptive statistics were used to summarize the patient characteristics, while the chi-square test was used to evaluate the associations between socio-demographic and clinical characteristics with the presence of DRPs, with a p-value <0.05 considered statistically significant.</p><p><strong>Results: </strong>DRPs were identified in 91 of 92 patients (98.9%), totaling 104 events. Most DRPs (87.5%) concerned treatment safety, while 12.5% involved treatment effectiveness. Patient-related factors (43.4%) and drug selection (33.3%) were primary causes. Common adverse effects included alopecia (88.0%) and anorexia (84.8%). A significant association was observed between adverse drug reactions (ADRs) and DRPs (Fisher's exact p-value = 0.011).</p><p><strong>Conclusion: </strong>DRPs were highly prevalent among breast cancer patients, mainly due to safety issues, with ADRs significantly contributing to it. Findings highlight the need for larger multicentric and cohort studies, and integration of oncology pharmacy services to optimize pharmaceutical care and minimize DRPs.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0334703"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The recurrence and mortality risk in Luminal A breast cancer patients who lived in high pollution area.","authors":"Pimwarat Srikummoon, Patrinee Traisathit, Wimrak Onchan, Chagkrit Ditsatham, Natthapat Thongsak, Nawapon Nakharutai, Salinee Thumronglaohapun, Titaporn Supasri, Phonpat Hemwan, Imjai Chitapanarux","doi":"10.1371/journal.pone.0335140","DOIUrl":"10.1371/journal.pone.0335140","url":null,"abstract":"<p><p>Luminal A is the most common subtype of breast cancer and has the best prognosis comparing to the others. The association between air pollution and survival of breast cancer have been reported but not specific to this subtype. We examined pollutant distributions over a decade in upper Northern Thailand, the area of high average annual particulate matter levels, and their impact on the mortality and recurrence risks of patients with luminal A breast cancer. Retrospective data of 1,305 luminal A breast cancer patients diagnosed from 2003 to 2018 were enrolled to this study. Cox proportional hazard models were used to identify factors associated with mortality and recurrence risks including all known risk factors and the annually averaged concentrations of pollutants. On multivariable analysis; metastatic stage (adjusted hazard ratio (aHR) =10.50; 95% confidence interval (95%CI): 7.23-15.25), smoking history (aHR = 1.72; 95% CI: 1.14-2.60), and age ≥ 50 years old (aHR = 1.46; 95% CI: 1.13-1.90) were significant factors influencing mortality risk. Factors contributing to recurrence risk included metastatic stage (aHR) 4.96 (95% CI: 2.78-8.83) and exposure to the time-updated local concentration of PM10 > 55 µg/m3 (aHR = 1.68; 95% CI: 1.16-2.45). Exposure to air pollutants is one of the detrimental factors affected to recurrence and mortality in luminal A subtype breast cancer.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0335140"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FoxO3a regulated by miR-150-5p promotes the pyroptosis of macrophages in atherosclerosis.","authors":"Ping-Yu Cai, Mei-Mei Li, Shu-Han Chen, Yan-Li Zheng, Jun Li, De-Hong Huang, Jing-Ru Du, Hui-Li Lin","doi":"10.1371/journal.pone.0327075","DOIUrl":"10.1371/journal.pone.0327075","url":null,"abstract":"<p><strong>Background: </strong>This study uses tissue exosome analysis to explore the role of miR-150-5p and its downstream genes in atherosclerosis (AS), an area where the functional mechanisms and pathophysiological significance of exosomal miR-150-5p remain poorly understood.</p><p><strong>Methods: </strong>Exosomes from AS mouse vascular tissue were analyzed to identify miR-150-5p target genes. Dual luciferase assays validated miRNA-target interactions, while RT-qPCR and Western blot assessed FoxO3a expression. RNA interference studies determined FoxO3a's role in pyroptosis. In vivo efficacy of the miR-150-5p inhibitor was evaluated using HE, Masson staining, and immunofluorescence.</p><p><strong>Results: </strong>In AS tissue exosomes, miR-150-5p levels increased whereas FoxO3a levels decreased. miR-150-5p regulated FoxO3a, enhancing macrophage pyroptosis. The miR-150-5p inhibitor reduced ox-LDL-induced RAW264.7 injury and pyroptosis by improving cell viability, decreasing LDH levels, and downregulating pyroptosis related proteins (Caspase-1, NLRP3, GSDMD-N). FoxO3a knockdown weakened the inhibitor's effects on NLRP3/GSDMD-mediated pyroptosis. In Apoe-/- mice, the inhibitor upregulated FoxO3a/ARC and suppressed pyroptosis signaling.</p><p><strong>Conclusion: </strong>This study advances understanding of miR-150-5p-mediated pyroptosis and highlights the potential of miR-150-5p inhibitors in combating AS.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0327075"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From protection to pollution: Evaluating environmental and human health risks of acaricide use in dairy farming in Kenya.","authors":"Kevin W Maina, Martin C Parlasca, Elizaphan E J O Rao","doi":"10.1371/journal.pone.0333694","DOIUrl":"10.1371/journal.pone.0333694","url":null,"abstract":"<p><p>Sustainable intensification of livestock production relies critically on effective disease management, yet the environmental implications of current practices remain poorly understood. The study was designed to evaluate the efficacy of acaricide use in tick control in Kenya's dairy sector affects environmental and human health risks. Using original survey data from dairy farmers and a two-stage least square (2SLS) approach, the results found that farmers' adaptation to perceived ineffective tick treatment leads to potentially harmful practices. Twenty percent of farmers improperly rotate acaricides, while 66% under-apply recommended doses. Despite 65% using protective gear, 29% report adverse health effects. Our estimates show that improper acaricide group rotation increases the environmental and human health risks by 35%. The study highlights important trade-offs between animal health management and environmental and human health objectives, suggesting a need to reform current disease prevention approaches to balance productivity gains with environmental sustainability in developing countries.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0333694"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial dysfunction-related metabolite methylmalonic acid is associated with decreased cognitive performance.","authors":"Yige Liu, Jiaxin Wang, Pengyan Wu, Fan Tang, Wanlu Guo, Ruishan Li, Xinran Wang, Yiying Zhang, Shaohong Fang","doi":"10.1371/journal.pone.0332987","DOIUrl":"10.1371/journal.pone.0332987","url":null,"abstract":"<p><strong>Purpose: </strong>Methylmalonic acid (MMA), a mitochondrial metabolite derived from propionate metabolism, has been implicated in fatal neurodegeneration in children with congenital methylmalonic acidemia. However, its clinical relevance in chronic cognitive decline remains poorly understood. This study aims to investigate the association between MMA levels, its metabolic coenzyme vitamin B12, and cognitive impairment in an elderly population.</p><p><strong>Patients and methods: </strong>The cohort comprised 2,762 participants aged 60 and older, who underwent assessments using the Digit Symbol Substitution Test (DSST), Animal Fluency test (AFT), Consortium to Establish a Registry for Alzheimer's disease (CERAD) Immediate Recall (CERAD-IR), CERAD Delayed Recall (CERAD-DR), with low cognitive performance defined as the bottom quartile. Generalized linear regression models were applied to explore potential associations. Additionally, differentially expressed genes (DEGs) in MMA-related propionate metabolic process were identified from the RNA expression profiles in frontal cortex from 56 Alzheimer's disease and 44 non-dementia controls.</p><p><strong>Results: </strong>Among the 2,762 participants, with a mean age of 69.2 years and 53.8% female, elevated MMA levels were significantly associated with an increased likelihood of low cognitive performance across multiple tests: DSST (OR = 1.95; 95% CI: 1.41-2.73), AFT (OR = 1.51; 95% CI: 1.01-2.25), CERAD-IR (OR = 1.58; 95% CI: 1.19-2.09), and CERAD-DR (OR = 1.56; 95% CI: 1.12-2.18). High serum vitamin B12 levels were associated with an increased likelihood of impaired CERAD-IR scores, although dietary B12 supplementation did not correlate with cognitive performance. Stratified analyses revealed a stronger relationship between MMA and cognitive decline in males, individuals over 75 years, and those with elevated serum and dietary vitamin B12 levels. DEG analysis identified genes related to MMA synthesis and mitochondrial function in cognitively impaired individuals, with significant enrichment in mitochondrial propionate metabolism pathways.</p><p><strong>Conclusion: </strong>The findings indicate that elevated MMA levels are linked to cognitive decline in older adults, potentially through mitochondrial dysfunction. These results underscore the clinical importance of MMA in the context of chronic cognitive impairment.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0332987"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duloxetine and pregabalin: High-dose monotherapy or their combination?-Study protocol for a randomized trial in patients with postoperative pain after total knee arthroplasty based on the classification of central sensitization inventory scores.","authors":"Haodong Wu, Shuxin Yao, Yuanchi Huang, Chao Xu, Jianbing Ma","doi":"10.1371/journal.pone.0334400","DOIUrl":"10.1371/journal.pone.0334400","url":null,"abstract":"<p><strong>Background: </strong>Residual pain after total knee arthroplasty (TKA) often causes patient dissatisfaction. Patients with preoperative central sensitization (CS) are especially susceptible to chronic pain after TKA. Although duloxetine and pregabalin are known to relieve pain in CS patients, there is limited evidence on the precise effectiveness and safety of increasing the dosage or combining these medications. To address this gap, we designed a randomized, triple-blind clinical trial to assess the efficacy and safety of increasing the maximum dosage or combining these drugs for patients who do not respond to standard doses.</p><p><strong>Methods: </strong>Patients scheduled to undergo primary unilateral TKA will be screened for CS using the central sensitization inventory (CSI). CS patients will then be randomly assigned to Groups 1-5, while non-CS patients will be assigned to Group 6. All groups will receive multimodal analgesia. Groups 1 and 6 will receive a placebo. During the initial 6-week period, Groups 2 and 3 will take 60 mg/day of duloxetine, while Groups 4 and 5 will take 300 mg/day of pregabalin. Subsequently, non-responders will enter a 6-week period of high-dose/combination therapy. Group 2 will receive 120 mg/day of duloxetine, Group 3 and 4 will receive a combination of 60 mg/day of duloxetine and 300 mg/day of pregabalin, and Group 5 will receive 600 mg/day of pregabalin. The primary outcome will be to compare residual pain intensity at 6 months between the high-dose monotherapy groups (Groups 2, 5 pooled) and the combination therapy groups (Groups 3, 4 pooled), which will be measured using the brief pain inventory (BPI) 24-hour average pain change. Secondary outcomes will assess pain and functionality.</p><p><strong>Discussion: </strong>This study aims to evaluate the efficacy and safety of increasing medication to the highest dose or combining two medications in patients with CS who have not responded well to standard doses of duloxetine or pregabalin after TKA. The goal is to provide clinicians with evidence-based recommendations for choosing an appropriate pain management strategy for these patients.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2400081990. Registered on 18 March 2024.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0334400"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a novel virtual reality training intervention to address implicit bias among healthcare workers, using an implementation science framework.","authors":"Madelyn Olmos-Rodriguez, Lynhea M Anicete, Nova Wilson, Luis Gutierrez-Mock, Jeremy N Bailenson, Ali Mirzazadeh, Orlando O Harris, Madhavi Dandu, Suzanne Welty, Alicia Fernandez, Elizabeth M Rojo, Savanna Harris, Kelly D Taylor, Michael J A Reid","doi":"10.1371/journal.pone.0331324","DOIUrl":"10.1371/journal.pone.0331324","url":null,"abstract":"<p><strong>Background: </strong>There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system.</p><p><strong>Methods: </strong>CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice.</p><p><strong>Results: </strong>Reach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses.</p><p><strong>Conclusions: </strong>In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0331324"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burdens of Gastroesophageal Reflux Disease in China: Findings from the 2021 GBD Study.","authors":"Zhiqiang Liang, Zehui Hou, Zhuomin Yu, Bing Zeng, Fang Li, Jingjing Wu, Yingru Li, Zhipeng Jiang","doi":"10.1371/journal.pone.0334719","DOIUrl":"10.1371/journal.pone.0334719","url":null,"abstract":"<p><p>As a major global health concern, Gastroesophageal Reflux Disease (GERD) has garnered widespread attention; However, to date, the prevalence of GERD across different ethnic groups in China has not been comprehensively examined by any large-scale epidemiological studies or meta-analyses. Against this backdrop, the present study draws on data from the Global Burden of Disease (GBD) Study to investigate the burden of GERD in China. Data from the 2021 GBD Study were utilized to assess the burden of GERD in China, focusing on key indicators such as prevalence, incidence, Years of Life Lived with Disability (YLDs), Age-Standardized Rates (ASR). Health inequality analyses were used to measure the inequality in the distribution of GERD across countries based on the Socio-Demographic Index (SDI), as well as to determine whether such inequality exists in China. Frontier analysis identified top performers in healthcare systems across different countries when examining the burden of GERD, followed by a comparison of differences in GERD burden between China and these top-performing countries. The trends of GERD from 2022 to 2044 were projected using the Nordpred and ARIMA model. Between 1990 and 2021, the prevalence of GERD in China experienced a notable rise of 60.62%. Correspondingly, the ASR also increased significantly. A similar pattern was Observed in incidence and YLDs, with number and ASR rising. A frontier analysis revealed that China had relatively low prevalence and incidence rates but a moderate-to-high level of SDI. Health inequality analysis revealed both absolute and relative inequalities related to SDI, with a noticeable increase in the inequality of the age-standardized GERD burden from 1990 to 2021. a significantly greater inequality in GERD burden was observed in China compared to other countries, suggesting a disparity in GERD distribution relative to SDI. Projections of GERD in China extending from 1990 to 2044 indicate a steady increase in the combined numbers and ASR of prevalence, incidence, and YLDs. The disease burden of GERD in China has risen steadily over the past three decades, with marked increases in the ASRs of its prevalence, incidence, and YLDs. Given the growing number of individuals affected by GERD, adapting healthcare systems to address the escalating demand for related services and treatments has become an urgent necessity.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 10","pages":"e0334719"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}