Nevin Manimala

Appl Psychophysiol Biofeedback. 2026 Apr 19. doi: 10.1007/s10484-026-09786-6. Online ahead of print.

ABSTRACT

This study aimed to evaluate the effectiveness of Magic Keys AR as a tool for accelerating vocal learning through synchronized monitoring of breathing, posture, and acoustics. The findings indicate that augmented reality facilitates faster vocal mastery, allowing students to visualize three parameters simultaneously-breathing, posture, and sound. The experiment involved 120 conservatory students aged 18-25 from three Chinese cities, divided into two groups of 60 participants each: the experimental group trained using the Magic Keys AR system, while the control group followed traditional mirror-based instruction. The training lasted 16 weeks. Respiration was measured via plethysmography, body movements were tracked across 37 anatomical points, and voice was recorded in high resolution (96 kHz/24 bit). Students using AR increased phonation duration by 34.1% (up to 16.5 s), while the control group showed a 10.4% increase (up to 13.8 s); the difference was statistically significant (p < 0.001, large effect size: d = 1.07). Vocal instability (jitter) decreased by 28.1% in the AR group versus 9.9% in the control, and shimmer decreased by 31.3% versus 8.2%, respectively. Retention rates reached 91% in the AR group and 68% in the control, with 89% of AR-trained students maintaining skills three months post-training. Machine learning algorithms predicted student success with 84.2% accuracy, identifying proprioceptive awareness (β = 0.34) as the strongest predictor. Conservatories are projected to recover AR investment 2.7 times faster due to reduced vocal strain, accelerated technical mastery, and lower dropout rates.

PMID:42001365 | DOI:10.1007/s10484-026-09786-6

Lab Med. 2026 Apr 3;57(3):lmag014. doi: 10.1093/labmed/lmag014.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic led to rapid global vaccine deployment, especially among high-risk groups, such as individuals living with HIV. Data are limited, however, on the immunologic effects of SARS-CoV-2 vaccination-specifically, on CD4+ and CD8+ T lymphocyte levels-in HIV-positive women in South Africa, a population with high HIV prevalence.

METHODS: This prospective cross-sectional study included 40 women (aged 14-42 years) admitted to a South African tertiary-care hospital, stratified by HIV and SARS-CoV-2 vaccination status. Flow cytometry (BD Multitest [BD Biosciences]) was used to determine absolute CD4+ and CD8+ T-cell counts. Data were analyzed with GraphPad Prism, version 8, software (GraphPad Software). The Mann-Whitney U test was used for comparisons between 2 independent groups. For comparisons across more than 2 groups, either a 1-way analysis of variance or the Kruskal-Wallis test was applied, with statistically significant results followed by the Dunn multiple comparisons test. Spearman correlation was used to assess relationships between variables. In all cases, statistical significance was defined as P < .05.

RESULTS: Of the 40 participants, 27 (68%) were HIV positive and 20 (50%) were vaccinated. CD4+ T-cell counts were statistically significantly higher in HIV-negative women than in HIV-positive women (P = .01), while CD8+ levels did not differ significantly (P = .41). Vaccination status had no statistically significant impact on CD4+ or CD8+ counts. The CD4/CD8 ratio was statistically significantly higher in HIV-positive women (P = .01), especially among the unvaccinated subgroup (P = .002).

CONCLUSIONS: SARS-CoV-2 vaccination did not substantially alter CD4+ or CD8+ T lymphocyte levels, regardless of HIV status.

PMID:42001311 | DOI:10.1093/labmed/lmag014

Pak J Pharm Sci. 2026 Jun;39(6):1888-1900. doi: 10.36721/PJPS.2026.39.6.180.1.

ABSTRACT

BACKGROUND: Long-term use of antipsychotics like risperidone raises metabolic syndrome (MetS) risk, with evidence from Chinese populations being limited.

OBJECTIVES: This study compared MetS prevalence and metabolic profiles between chronic schizophrenia patients on long-term risperidone versus olanzapine.

METHODS: In this cross-sectional study, 80 risperidone-treated patients were compared to 80 olanzapine-treated controls. MetS [IDF (The International Diabetes Federation) criteria], glucose/lipid metabolism and anthropometric measures were assessed. Statistical analyses included t-tests and χ^² tests.

RESULTS: The prevalence of MetS was significantly lower in the risperidone group (30.0%) compared to the olanzapine group (48.8%, p = 0.015). Risperidone patients showed better glycemic control and lipid profiles (p < 0.05), though BMI (body mass index), waist circumference and blood pressure remained elevated compared to olanzapine patients.

CONCLUSION: Long-term risperidone therapy is associated with a lower MetS risk than olanzapine. Regular metabolic monitoring and adjunctive interventions are recommended for high-risk patients.

PMID:42001294 | DOI:10.36721/PJPS.2026.39.6.180.1

Pak J Pharm Sci. 2026 Jun;39(6):1854-1861. doi: 10.36721/PJPS.2026.39.6.176.1.

ABSTRACT

BACKGROUND: Childhood acute lymphoblastic leukaemia (cALL) tends to metastasize to central nervous system. Treatment with antileukemic agents against CNS leukaemia is an essential component for cure in ALL. Hence, it is essential to identify biomarkers for CNS infiltration. Proteomics, supported by mass spectrometry, is the platform for exploring biomarkers in various biological samples, contributing to translational research.

OBJECTIVES: This study aimed to identify the plasma proteome profile of children across different risk groups of cALL. Neurexophilin and PC-esterase family, member 3 (NXPE3), was validated. The protein-protein interactions (PPI) of NXPE3 were evaluated with bioinformatics analyses.

METHODS: Plasma samples from 15 patients with B-ALL standard risk (SR), B-ALL high risk (HR) and T-ALL high risk (HR), were analysed using LC-MS/MS. NXPE3 protein was validated in all risk groups using ELISA. To compare the NXPE3 values across groups, the Kruskal-Wallis test was applied. A p-value < 0.05 was considered significant. STRING database was used for PPI.

RESULTS: LC MS/MS analysis showed upregulation of NXPE3 in B-ALL SR. Upon ELISA validation, a high plasma concentration of NXPE3 was observed in B-ALL SR, 4.37±1.84 ng/ml (95% CI 3.31, 5.44), consistent with LC MS/MS findings. A lower concentration of NXPE3 was observed in B-ALL HR 2.68±1.34 ng/ml and T-ALL HR 2.38±0.92ng/ml. The findings were statistically significant. The PPI of NXPE3 highlighted its involvement in multiple processes, including gene expression, cytoskeletal organisation and neuronal function.

CONCLUSION: This is the first report of NXPE3 in cALL. NXPE3 was identified as a potential biomarker for assessing CNS infiltration in cALL. Further studies are recommended to explore its role in leukemogenesis.

PMID:42001290 | DOI:10.36721/PJPS.2026.39.6.176.1

Pak J Pharm Sci. 2026 Jun;39(6):1802-1816. doi: 10.36721/PJPS.2026.39.6.171.1.

ABSTRACT

BACKGROUND: Antimicrobial resistance (AMR) is a growing global health threat, primarily driven by the inappropriate use of antibiotics and unsafe disposal practices. In developing countries like Pakistan, the misuse of leftover antibiotics through self-medication and improper disposal remains a poorly addressed public health concern.

OBJECTIVES: This study aimed to describe the prevalence, patterns and associated factors of self-reuse and disposal practices of leftover antibiotics among residents of Karachi, Pakistan and to identify gaps affecting antibiotic stewardship.

METHODS: A descriptive, cross-sectional study was conducted using a validated online questionnaire targeting adults (≥18 years) residing in Karachi. A total of 385 responses were collected via non-probability sampling. The study was conducted from 10/02/2025 to 03/06/2025. Descriptive statistics and chi-square tests were applied using SPSS version 26 to evaluate associations between sociodemographic factors and antibiotic-related behaviours.

RESULTS: Approximately 24% of participants did not complete their prescribed antibiotic course, predominantly because of symptom resolution. Over half (56%) reported retaining leftover antibiotics and 43% admitted to reusing them without professional consultation, largely due to previous successful outcomes. A significant association was observed between educational level and perceptions of the safety of antibiotic reuse (p < 0.001). Disposal practices were suboptimal, with 70% discarding expired antibiotics in household trash and only 8% utilizing pharmacy take-back services. Counselling on proper disposal varied significantly by socioeconomic status (SES) (p = 0.009), with the highest rate reported among low SES participants (37.5%), but overall awareness of disposal programs remained low.

CONCLUSION: The findings highlight concerning patterns in antibiotics storage, self-use and disposal practices in Karachi. These patterns suggest a need for public educational, pharmacist-led interventions and improved access to medication take-back programs to promote safer practices and reduce AMR risk.

PMID:42001285 | DOI:10.36721/PJPS.2026.39.6.171.1

Pak J Pharm Sci. 2026 Jun;39(6):1792-1801. doi: 10.36721/PJPS.2026.39.6.170.1.

ABSTRACT

BACKGROUND: Inpatient care for Alzheimer’s disease (AD), often complicated by comorbidities, frequently involves polypharmacy (≥5 medications). The profile and cognitive consequences of sustained polypharmacy in these elderly inpatients require further investigation.

OBJECTIVES: To investigate the status of polypharmacy in elderly inpatients with AD and its correlation with three-year cognitive outcomes, so as to provide a basis for clinical optimization of medication regimens.

METHODS: This study was a retrospective propensity score matching (PSM) cohort study. 300 AD inpatients who were hospitalized from March 2022 to March 2025 were included. Patients were stratified into polypharmacy and non-polypharmacy groups according to their polypharmacy status. The primary outcome was the incidence of cognitive decline (MMSE decline ≥3 points) at 3 years. Secondary outcomes were the association of CDR progression, rate of decline in MoCA, incidence of falls, all-cause rehospitalization, all-cause mortality and anticholinergic drug burden with cognitive outcomes.

RESULTS: After PSM, baseline characteristics were balanced (p>0.05). At the 3-year follow-up, the polypharmacy group had a significantly higher incidence of cognitive decline than the non-polypharmacy group (64.0% vs. 38.0%; RR=1.68, 95% CI: 1.33-2.13, p<0.001). Polypharmacy was also associated with faster CDR progression, a greater annual rate of MoCA decline and increased risks of falls (RR=1.82, p<0.01) and all-cause rehospitalization (RR=1.67, p<0.001). A high anticholinergic burden (ACB score ≥3) was identified as an independent predictor of cognitive decline (OR=2.5, 95%CI: 1.7-3.7, p<0.001).

CONCLUSIONS: Our findings highlight polypharmacy as a key, modifiable risk for cognitive decline in AD, calling for structured medication management to mitigate this risk.

PMID:42001284 | DOI:10.36721/PJPS.2026.39.6.170.1

J Laparoendosc Adv Surg Tech A. 2026 Apr 19:10926429261445559. doi: 10.1177/10926429261445559. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic surgery (Lap) is widely recognized as the standard minimally invasive method for colorectal surgeries. Although robotic surgery (Rob) has seen increased adoption, its application in inflammatory bowel disease remains uncertain.

METHODS: A systematic search was conducted across PubMed, Scopus, and the Cochrane Central Register of Controlled Trials up to February 2026. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed via the inconsistency (I²) statistic. Trial sequential analysis (TSA) was applied to assess the robustness of the cumulative evidence.

RESULTS: Four observational studies, including 3776 patients, were analyzed; 246 underwent Rob and 3530 underwent Lap. Compared with Lap, Rob was associated with a significantly lower rate of overall postoperative complications (OR: 0.56; 95% CI: 0.31 to 0.99; P = .047). No significant differences were observed between approaches in postoperative ileus (OR: 1.16; 95% CI: 0.67 to 2.01; P = .595), anastomotic leak (OR: 0.92; 95% CI: 0.38 to 2.22; P = .852), surgical site infection (OR: 0.70; 95% CI: 0.36 to 1.36; P = .297), reoperation (OR: 1.00; 95% CI: 0.42 to 2.35; P = .997), or stoma formation (OR: 0.47; 95% CI: 0.18 to 1.25; P = .130). The length of hospital stay was similar between groups (MD: = -0.20 days; 95% CI: = -0.80 to 0.31; P = .37). Operative time was significantly longer in Rob (MD: + 51.8 minutes; 95% CI: 32.0 to 71.6; P < .001). TSA indicated that most outcomes remained underpowered, suggesting a persistent risk of random error.

CONCLUSION: Rob for Crohn’s disease is a safe and feasible minimally invasive approach, with lower overall postoperative complications than Lap. However, Rob was associated with longer operative times, while most perioperative outcomes remain comparable. Further well-designed prospective studies are required to confirm these findings.

PMID:42001279 | DOI:10.1177/10926429261445559

Cell J. 2026 Feb 28;27(1):1-13. doi: 10.22074/cellj.2026.2050175.1770.

ABSTRACT

OBJECTIVE: A paternal high-fat diet (HFD) has been shown to affect the expression of peroxisome proliferator-activated receptors (Ppars), particularly in offspring’s testicle regions. One of its isoforms, Pparγ, participates in spermatogenesis as a transcription factor regulating fatty acid metabolism genes. This study aimed to investigate how paternal dietary intake of trans fatty acids and/or vitamin E influences the expression of Pparγ target genes in the testes of their offspring, with the goal of elucidating potential mechanisms related to altered lipid metabolism and reproductive health.

MATERIALS AND METHODS: In this experimental study, adult male Wistar rats (F0) were fed for 60 days with one of the following four diets: control diets (C), control diets with trans fatty acids (CTH), diets containing vitamin E (E) and diets containing vitamin E and trans fatty acids (ETH). Then the male offspring (F1) were raised on standard chow, and their testicular tissue was later analyzed to assess the impact of paternal diet on gene expression, and the expression of the Pparγ target genes: Elovl2, Muc1, Fads2, Scd1, Glut2 and Lpl were measured quantitatively.

RESULTS: The data revealed that paternal HFD can suppress the expression of Pparγ target genes in the testes of offspring. Fads2, Elovl2 were significantly upregulated in response to paternal vitamin E supplementation. The changes in Lpl gene expression were not statistically significant. Also, co-expression analysis and functional enrichment approach indicated that the genes involved in cellular response to fatty acid, fatty acid metabolic process, lipid storage, and fatty acid biosynthetic process were overexpressed in up/down regulated Pparγ target genes.

CONCLUSION: Our findings demonstrate the metabolic impact of paternal diet on offspring’s, with focus on mechanisms related to altered lipid metabolism and reproductive health.

PMID:42001274 | DOI:10.22074/cellj.2026.2050175.1770

Ann Saudi Med. 2026 Mar-Apr;46(2):137-149. doi: 10.5144/0256-4947.2026.137. Epub 2026 Apr 16.

ABSTRACT

BACKGROUND: Messenger RNA (mRNA)-based influenza vaccines represent a promising advancement in seasonal influenza prevention. However, comprehensive evaluation of their serious safety profile is essential as these vaccines progress toward widespread clinical use. While individual randomized controlled trials (RCTs) have reported low rates of serious adverse outcomes, pooled evidence is limited.

OBJECTIVE: This systematic review and meta-analysis of RCTs aim to assess the risk of serious adverse events (SAEs) and adverse events of special interest (AESIs) associated with mRNA-based seasonal influenza vaccines in adults.

DESIGN: Systematic review and meta-analysis.

SETTING: All RCTs included in the meta-analysis were carried out in the USA.

METHODS: A systematic literature search was done until December 2025. RCTs evaluating mRNA-based influenza vaccines in adults and reporting participant-level data for SAEs and/or AESIs were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled.

MAIN OUTCOME MEASURES: Risks of SAEs and AESIs associated with mRNA-based seasonal influenza vaccines in adults, expressed as pooled risk ratios with 95% CIs.

SAMPLE SIZE: Seven RCTs (containing 12 datasets) were included in this meta-analysis. The total number of cases in the intervention and comparator groups were 23,754 and 22,806 respectively.

RESULTS: The pooled analysis demonstrated no increased risk of SAEs (RR=0.90, 95% CI: 0.64-1.27, P=.56) and AESI (RR=0.76, 95% CI: 0.41-1.36, P=.35) among mRNA vaccine recipients compared with controls.

RISK OF BIAS: Based on funnel plots, there is no evidence of systematic asymmetry or absence of smaller studies with null or adverse findings. Risk-of-bias assessment using the Cochrane traffic-light framework indicated low risk across all domains in all included RCTs.

HETEROGENEITY: The heterogeneity was low-to-moderate (τ²=0.08; I²=27.79%; H²=1.38) for SAEs and the Q-test indicated statistically significant heterogeneity (Q=14.46, P=.21). For AESIs, heterogeneity was absent (τ²=0.00; I²=0.00%; H²=1.00), with no evidence of between-study variability by the Q-test (Q=4.70, P=.94).

CONCLUSIONS: Pooled evidence shows that mRNA-based seasonal influenza vaccines are not associated with an increased risk of SAEs or AESIs compared with established influenza vaccines or placebo.

LIMITATIONS: Low absolute number of AESIs limiting detection of extremely rare events, limited long-term follow-up beyond early and intermediate risk windows, and potential differences between trial populations and real-world vaccine recipients.

REGISTRATION: CRD420251271174.

PMID:42001264 | DOI:10.5144/0256-4947.2026.137

J Periodontol. 2026 Apr 19. doi: 10.1002/jper.70136. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate whether healthcare expenditures (HCEs) differed depending on whether the patients left periodontal disease (PD) untreated, despite the need for treatment.

METHODS: This study used public PD screening data from a municipality in Japan to identify adults aged ≥ 40 years who were found to require treatment of PD by dentists at PD screening. The presence or absence of periodontal treatment was determined by a dental visit within 180 days after the date of PD screening based on medical claims data. Annual HCE were calculated from cumulative expenditures over 2 years from the date of the presence or absence of periodontal treatment. A generalized linear model with a gamma distribution and log link function was used to calculate the relative cost ratios (RCRs) and 95% confidence intervals (95% CI), and a two-part model was used to predict annual HCEs and the difference in predicted HCEs based on dental treatment.

RESULTS: Among 652 people (mean age: 62.6 years [1 SD = 9.0], 65.5% women), 9.0% were untreated. After adjusting for the covariates, the RCR for medical, pharmaceutical, and dental costs in the untreated group compared with the treated group were 1.56 (95% CI: 1.02-2.38), 0.95 (95% CI: 0.53-1.70), and 0.14 (95% CI: 0.10-0.19), respectively. The differences in predicted HCEs were $593.5 (95% CI: -280.6, 1467.6) higher for medical, $79.9 (95% CI: -363.6, 523.4) higher for pharmaceutical, and $323.9 (95% CI: -397.3, -250.6) lower for dental.

CONCLUSION: Leaving PD untreated was associated with increased HCEs, particularly medical expenditures.

PLAIN LANGUAGE SUMMARY: This study looked at whether people who were told by a dentist that they needed care for periodontal disease actually received treatment, and how this affected their healthcare costs. The research followed more than 600 adults in Japan for 2 years, comparing the cumulative healthcare costs of those who received dental care with those who did not. The results showed that people who did not treat their periodontal disease ended up spending more on medical care, even though they spent less on dental care. On average, untreated individuals had medical expenses that were around $600 higher than those who received treatment. This suggests that avoiding dental care for periodontal disease might lead to more serious health problems down the line, which can increase overall healthcare costs. Although skipping dental visits may seem like a way to save money, it could actually lead to higher medical bills in the future. These findings highlight the importance of early dental treatment not just for oral health, but also for managing overall healthcare costs and preventing other health complications.

PMID:42001258 | DOI:10.1002/jper.70136