Category: Nevin Manimala

Pediatr Pulmonol. 2026 Aug;61(8):e71804. doi: 10.1002/ppul.71804.

ABSTRACT

INTRODUCTION: The emergence of new disease-modifying treatments for type I spinal muscular atrophy (SMA I) has led to a paradigm shift in the respiratory management of these patients. Accompanying pulmonary and thoracic growth appears to be a key factor in their morbidity and mortality. The role of Intermittent Positive Pressure Breathing (IPPB) on thoracic growth has been described in the literature, but there are few studies available to objectively assess its impact.

STUDY OBJECTIVE: To assess the impact of using IPPB on thoracic growth in children with SMA I.

MATERIAL/METHOD: In this bicentric retrospective study, the thoracic circumference-to-head circumference ratio (TC/HC) was compared at three time points: 4 months before the initiation of IPPB, at the start of IPPB, and 4 months after initiation.

RESULTS: Seven children (3 girls and 4 boys) with SMA I with a median (min-max) age of 4.8 (2.6-8.2) years old were included in this study. A statistically significant increase was observed in the mean change in TC/HC between the pre-IPPB and post-IPPB periods (-0.05 ± 0.03 vs. +0.06 ± 0.07, p = 0.04).

CONCLUSION: In this study, IPPB was associated with a significant increase in TC/HC in children with SMA I. Further large-scale studies are warranted to better characterize the extent and clinical significance of this effect.

PMID:42634913 | DOI:10.1002/ppul.71804

Pediatr Pulmonol. 2026 Aug;61(8):e71803. doi: 10.1002/ppul.71803.

ABSTRACT

BACKGROUND: Optimal inhaler technique (IT) is essential for effective asthma management, yet skill retention among health care professionals (HCPs) remains inconsistent.

AIM: To compare the long-term effectiveness of intensive versus brief educational interventions on IT retention among HCPs in pediatric emergency departments (PEDs) across Northern Greece.

METHODS: We conducted a 12-month prospective, multicenter intervention study in 20 PEDs. Pediatric consultants, residents, and nurses were allocated to either an intensive education group-receiving IT training every 4 months-or a brief education group-receiving a single training session. Blinded assessments of IT skills were performed alongside structured questionnaires on asthma crisis management and IT with both a facemask and a mouthpiece. Final evaluations were conducted at 12 months.

RESULTS: A total of 373 HCPs participated: 84 consultants, 178 residents, and 111 nurses. Post-intervention scores improved significantly for consultants (asthma crisis management: 69.94 to 76.54, p = 0.006; IT with facemask: 37.5 to 50, p = 0.003; IT with mouthpiece: 50 to 75, p = 0.005) and residents (61.15 to 70.89, p = 0.004; 25 to 50, p = 0.005; 50 to 75, p = 0.01, respectively). Intensive education was associated with significantly greater improvements compared with brief education, particularly among consultants (p = 0.003 for asthma crisis management). Nurses did not demonstrate statistically significant improvements.

CONCLUSIONS: Intensive, repeated training produces superior long-term retention of IT skills among HCPs in PEDs compared with a single educational session. Incorporating structured, ongoing educational strategies into routine practice may enhance asthma care delivery and reduce reliance on nebulizers in acute pediatric settings.

PMID:42634896 | DOI:10.1002/ppul.71803

Ren Fail. 2026 Dec;48(1):2714693. doi: 10.1080/0886022X.2026.2714693. Epub 2026 Aug 24.

ABSTRACT

BACKGROUND: Sleep disturbances are common in chronic kidney disease (CKD), yet patient priorities, reporting behaviors, and experiences of sleep management remain poorly understood. This study explored perceived causes of sleep disturbance, patient-prioritized sleep outcomes, and experiences of reporting and managing sleep problems.

METHODS: A multicenter, convergent mixed-methods study of adults with CKD stage 4-5, including those receiving kidney replacement therapy. Participants were recruited from four nephrology units across three Australian states. Survey data were analyzed using descriptive statistics and subgroup comparison, and interview data using thematic analysis, with findings integrated through triangulation.

RESULTS: A total of 234 participants completed the survey and 14 participated in interviews. Participants were predominantly male (67%), aged over 60 years, and receiving hemodialysis (62%). Overall, 73% were classified as poor sleepers. Fragmented sleep (56%), nocturia (44%), and restless legs syndrome (27%) were the most common contributors. Feeling refreshed on waking and satisfaction with sleep were the highest-priority outcomes, ranked above social participation, ability to work, and hospital admissions. Forty-one percent reported that their treating team had never asked about sleep, and among those who raised concerns, almost one-quarter received no management. Pharmacological therapy was the most commonly reported clinical management (33%), despite a preference for nonpharmacological strategies. Nine percent used a wearable sleep tracker; with a further 41% willing to try one.

CONCLUSION: In this cohort, sleep disturbances were common, under-recognised, and inconsistently managed. Management approach does not fully align with patient preferences. Greater access to nonpharmacological approaches and wearable technologies may support monitoring and engagement.

PMID:42634875 | DOI:10.1080/0886022X.2026.2714693

FASEB J. 2026 Aug 31;40(16):e72181. doi: 10.1096/fj.202602684RR.

ABSTRACT

To explore the effects of personalized exercise prescriptions and 5G-supported remote rehabilitation on adherence, lipid levels, cardiorespiratory fitness, and vascular function in patients after percutaneous coronary intervention (PCI), as well as to conduct a correlation analysis. This study employed a randomized, prospective clinical trial design, enrolling 155 patients at the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from September 2024 to September 2025. Patients were divided into a conventional group (n = 81) and a 5G remote monitoring group (n = 74), with the intervention lasting for 12 months. The 5G group utilized wearable devices for real-time monitoring. There were no statistically significant differences in baseline characteristics between the two groups (p > 0.05), indicating comparability. Correlation analysis revealed strong positive correlations among peak oxygen uptake (peak VO₂), peak work rate (Peak WR), oxygen uptake at anaerobic threshold (VO₂ at AT), and peak metabolic equivalents (peak METs) in the overall observed parameters (r > 0.8); peak VO₂ was positively correlated with left ventricular ejection fraction (LVEF) (r > 0.4). Vascular function showed positive correlations between Flow-Mediated Slowing of pulse wave velocity (FMS) and left atrial diameter (LA), the ratio of early mitral inflow velocity to mitral annulus velocity (E/e’), and left ventricular end-diastolic diameter (LVEDD), while carotid-femoral pulse wave velocity (cf-PWV) was negatively correlated with CPET parameters, and there was a strong positive correlation between bilateral ankle-brachial index (ABI). The Gini index ranking indicated that cf-PWV, LVEF, age, peak VO₂, and Peak WR had the most significant impact on FMS. After a 12-month follow-up, the improvements in LDL-C in the traditional group were superior to those in the 5G remote monitoring group (p < 0.05). However, the 5G remote monitoring group showed significant improvements in LVEF, E/e’, LA, LVEDD, FMS, and cf-PWV compared to the traditional group (all p < 0.05). Factor analysis indicated that in the 5G remote monitoring group, VO₂ at AT and Peak WR were the main positively correlated influencing factors for FMS (p < 0.05), while Peak WR was a key factor affecting cf-PWV in relation to LDL-C (p < 0.05). The integrated remote comprehensive rehabilitation program established through 5G wearable real-time monitoring significantly enhanced the rehabilitation compliance and exercise endurance of PCI patients. FMS and cf-PWV can intuitively reflect the vascular improvement effects brought about by multidimensional interventions and serve as core indicators for assessing the recovery of vascular injury after PCI. Although literature supports that 5G may confer benefits through the shear stress-eNOS-NO and ox-LDL-MMP pathways, this study did not measure the relevant biomarkers; thus, this mechanism remains hypothetical and requires validation in future research.

PMID:42634872 | DOI:10.1096/fj.202602684RR

Psychol Rep. 2026 Aug 24:332941261484082. doi: 10.1177/00332941261484082. Online ahead of print.

ABSTRACT

Exposure to traumatic events such as disasters, violence, and wars through social media has been associated with psychological distress and secondary traumatic stress (STS). However, limited evidence exists regarding how mindfulness and social sensitivity are associated with this digital form of trauma. This study examined the relationships among mindfulness, social sensitivity, and STS among social media users and tested the mediating role of social sensitivity. A descriptive, cross-sectional study was conducted in April 2025 with 433 social media users in Türkiye. Data were collected using the Secondary Traumatic Stress Scale for Social Media Users (STSS-SM), the Social Sensitivity Scale (SSS), and the Mindful Attention Awareness Scale (MAAS). Correlation and mediation analyses were performed using PROCESS Model 4. There was a weak but statistically significant negative correlation between STSS-SM scores and both SSS and MAAS scores (p < .001). Mediation analysis indicated that social sensitivity showed a statistically significant indirect association in the relationship between mindfulness and STS (p < .001). Participants reporting longer daily social media use had higher STS and lower mindfulness and social sensitivity levels. Higher mindfulness and social sensitivity were associated with lower levels of social media-related STS. Mindfulness-based psychoeducational interventions may represent promising approaches for supporting psychological well-being in digital environments.

PMID:42634855 | DOI:10.1177/00332941261484082

Q J Exp Psychol (Hove). 2026 Aug 24:17470218261484734. doi: 10.1177/17470218261484734. Online ahead of print.

ABSTRACT

Using a head-mounted virtual reality system, we investigated the ability of skilled volleyball players to perceive virtual volleyball serves, and to use such information to control their actions in receiving serves. We compared shorter and taller groups of competitive players, and we varied the height of incoming serves. In two experiments, we found that, with very rare exceptions, participants used either an overhead or underhand technique to receive serves. Technique selection was reliably related to serve height, such that the overhead technique was used for higher serves and the underhand technique for lower serves. In Experiment 1, participants were free to move in any way they wished in receiving serves. We found that participants tended to step backward prior to receiving higher serves, such that there was a statistically significant relation between the serve height, the magnitude of backward stepping, and the likelihood of the overhead technique. In Experiment 2, participants were not permitted to step in any direction. Here, we found that participants tended to jump prior to receiving higher serves, such that there was a statistically significant relation between serve height, jump height, and the likelihood of the overhead technique. We argue that participants perceived higher order affordances for using anticipatory whole-body movements to optimize the two serve reception techniques. We interpret our results as an extension of the concept of affordance-based control.

PMID:42634854 | DOI:10.1177/17470218261484734

Med Phys. 2026 Sep;53(9):e70646. doi: 10.1002/mp.70646.

ABSTRACT

BACKGROUND: Boron neutron capture therapy (BNCT) is a binary radiotherapy that selectively kills tumor cells. Its clinical implementation relies on Monte Carlo (MC)-based treatment planning systems, which are time-consuming and limit clinical workflow efficiency.

PURPOSE: To address this limitation, we propose a Multi-Fidelity MC-based Dual-Branch Network (MFMC-DBN) that leverages complementary information from low- and high-fidelity MC simulations through dual-branch feature fusion, enabling accurate and efficient BNCT dose calculation.

METHODS: The model was trained, validated, and tested using clinical data from 112 glioblastoma patients. Low-statistics coarse and fine mesh MC dose distributions (6.5×10⁶ particle histories) and patient CT information were used to predict three-dimensional dose distributions. Performance was compared with an MC denoising method and a conventional neural network (NN) approach.

RESULTS: MFMC-DBN outperformed both the NN and MC denoising methods across evaluated metrics. It achieved a mean absolute percentage error (MAPE) of 1.98% in the gross tumor volume (GTV). Organ-specific MAPEs ranged from 1.1% to 3.9%, with a maximum mean absolute error (MAE) of0.28 Gy (RBE). Gamma analysis further showed high spatial agreement, with passing rates of 99.8% within the patient contour and 99.3% in the GTV under the 3%/3 mm criterion. The proposed method maintained high dosimetric accuracy while substantially accelerating BNCT dose calculation.

CONCLUSIONS: MFMC-DBN effectively integrates multi-fidelity MC information through a dual-branch attention mechanism, enabling rapid and accurate 3D BNCT dose prediction. By significantly reducing computation time compared with full MC simulations while preserving dosimetric fidelity, these results support the feasibility of the proposed framework for accelerated BNCT dose calculation under a fixed beam configuration.

PMID:42634850 | DOI:10.1002/mp.70646

Exp Oncol. 2026 Aug 21;48(2):152-160. doi: 10.15407/exp-oncology.2026.02.152.

ABSTRACT

BACKGROUND: Lung cancer remains the leading cause of cancer mortality worldwide, with increasing incidence in many developing countries. Understanding region-specific risk factors is essential for effective prevention strategies. This study aimed to identify major determinants of lung cancer in North Sumatra, Indonesia.

MATERIALS AND METHODS: A hospital-based observational study with a case-control analytical approach was conducted between August and November 2024 in three referral hospitals in North Sumatra. A total of 240 patients with histologically confirmed lung cancer and 240 controls without malignancy or chronic respiratory disease were included. Participants were comparable by sex and residential area, while age differences between groups were statistically adjusted in the multivariate regression model.

RESULTS: Smoking exposure differed significantly between cases and controls (p = 0.023). The multivariate analysis identified several independent predictors of lung cancer. Age <45 years increased the risk more than two-fold (OR 2.62; 95% CI 1.10-6.21), whereas age >65 years showed a lower relative risk (OR 0.54; 95% CI 0.33-0.88). The occupational exposure signicantly increased lung cancer risk (OR 1.91; 95% CI 1.13-3.25). Unhealthy indoor environments, characterized by poor ventilation and household pollutant exposure, were also associated with an increased risk (OR 2.53; 95% CI 1.45-4.40). Chronic respiratory diseases, particularly tuberculosis and chronic obstructive pulmonary disease, were more prevalent among cases and contributed to the elevated risk.

CONCLUSIONS: Smoking exposure, occupational hazards, unhealthy indoor environments, and chronic pulmonary diseases are important determinants of lung cancer in North Sumatra. Public health strategies focusing on tobacco control, improved workplace safety, and reduction of indoor air pollution may substantially reduce lung cancer burden in this region.

PMID:42634841 | DOI:10.15407/exp-oncology.2026.02.152

Vet World. 2026 Jul 31;19(7):2816-2849. doi: 10.14202/vetworld.2026.2816-2849. Epub 2026 Jul 10.

ABSTRACT

BACKGROUND AND AIM: Catch-neuter-vaccinate-release (CNVR) is recognized as a humane and sustainable strategy for controlling free-roaming dog populations and eliminating dog-mediated rabies. However, long-term evaluations incorporating spatial planning and community participation remain scarce. This study assessed a five-year zoned CNVR program integrating owner engagement and a peripheral buffer zone strategy in Anuradhapura, Sri Lanka, a religious heritage city affected by frequent puppy dumping and high densities of free-roaming dogs.

MATERIALS AND METHODS: From 2021 to 2025, sexually intact free-roaming dogs were captured along predefined routes with standardized effort, while owned dogs were voluntarily presented to clinics. The municipality was divided into three zones according to anthropogenic characteristics, and a surrounding buffer zone was progressively intensified. Population trends were analyzed using negative binomial regression models. A questionnaire survey conducted in 2025 evaluated anti-rabies vaccination (ARV) and sterilization coverage among owned dogs. Spatial and household-level factors influencing coverage were examined using generalized linear mixed models.

RESULTS: The number of free-roaming dogs requiring sterilization declined from 1,368 in 2021 to 484 in 2025. Although annual declines in community dog counts per unit effort were not statistically significant, buffer zone interventions produced significant sex- and zone-specific effects, reducing male populations in zone 1 and female populations in zone 3. Owned dog numbers increased by 14.7% annually, primarily because female ownership increased by 24.1%. More than 78% of adult female dogs were sterilized. Questionnaire responses from 1,123 participants showed that 94.2% and 83.1% of owned dogs within and outside the municipality, respectively, had received at least one ARV, while annual vaccination coverage was 74.2% and 68.9%, respectively. Household-level analyses demonstrated that geographic location, rather than the number of dogs per household, explained most of the variation in vaccination and sterilization coverage, identifying several low-coverage locations that require targeted interventions.

CONCLUSION: A strategically zoned CNVR program incorporating owner participation and a boundary-sealing buffer zone effectively promoted humane management of the dog population and improved rabies control. Spatially targeted interventions and continued vaccination and sterilization campaigns are essential for achieving sustainable elimination of dog-mediated rabies in culturally complex urban environments.

PMID:42634835 | PMC:PMC13500148 | DOI:10.14202/vetworld.2026.2816-2849

Cureus. 2026 Jul 24;18(7):e113294. doi: 10.7759/cureus.113294. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Predictable decontamination of exposed implant surfaces remains difficult to achieve in peri-implantitis therapy. Rough sandblasted, large-grit, acid-etched (SLA) surfaces and implant thread geometry may promote biofilm retention and limit the effectiveness of chemical antiseptics and mechanical instrumentation.

OBJECTIVE: This controlled in vitro study compared the antimicrobial efficacy of three clinically relevant decontamination approaches: 0.12% chlorhexidine (CHX), GalvoSurge electrolytic cleaning, and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation against Staphylococcus aureus biofilms formed on Straumann SLA tissue-level implants in a standardized peri-implant defect model.

METHODS: Forty-eight Straumann SLA tissue-level implants were fixed in custom three-dimensional (3D)-printed peri-implant defect models and individually contaminated with Staphylococcus aureus and incubated in brain-heart infusion broth for 72 hours at 37°C. Implants were randomly assigned to four groups (n = 12/group): untreated control, CHX immersion for 60 s, GalvoSurge electrolytic cleaning for 120 s, or Er,Cr:YSGG laser treatment (2780 nm; 2.5 W; 30 Hz; 70% water; 60% air; 30 s). Residual viable bacteria were recovered using a standardized microbrush protocol and expressed as log10(colony-forming units (CFU)/implant).

RESULTS: Mean log10(CFU/implant) values were highest in the untreated control group (5.09 ± 0.33), followed by CHX (4.03 ± 0.12), GalvoSurge (3.77 ± 0.25), and Er,Cr:YSGG laser treatment (2.52 ± 0.39). The corresponding reductions relative to control were approximately 1.06 log10 for CHX, 1.32 log10 for GalvoSurge, and 2.57 log10 for laser treatment. Statistical analysis demonstrated a significant treatment effect (p < 0.001), with laser irradiation achieving the greatest reduction in viable bacterial counts under the tested conditions.

CONCLUSION: All active protocols reduced viable Staphylococcus aureus counts compared with untreated implants. Within the limitations of this single-species in vitro model, Er,Cr:YSGG laser irradiation achieved the greatest reduction, whereas GalvoSurge and CHX resulted in moderate and comparable decreases. Further studies incorporating multispecies biofilms, assessment of implant surface integrity, and clinically relevant outcomes are warranted.

PMID:42634830 | PMC:PMC13500086 | DOI:10.7759/cureus.113294