Category: Nevin Manimala

J Nutr Health Aging. 2026 Apr 7;30(5):100837. doi: 10.1016/j.jnha.2026.100837. Online ahead of print.

ABSTRACT

BACKGROUND: The effects of exercise snacks interventions on physical function in healthy or sub-healthy adults remain unclear. Exercise snacks intervention is defined as breaking up daily physical activity into brief, frequent bouts performed intermittently throughout the day (e.g., 1-2 min of stair climbing or bodyweight training hourly). This study aims to evaluate the effectiveness of exercise snacks interventions in improving physical function in this population.

METHODS: The systematic search covered the China National Knowledge Infrastructure (CNKI), China Science and Technology Journals (VIP), Wanfang, PubMed, Embase, CINAHL, Web of Science, Cochrane Library, and Scopus databases, screening relevant randomized controlled trials published up to July 31, 2025. The risk of bias in the included studies was assessed using the Cochrane risk of bias tool, and data analysis was performed with RevMan 5.3.

RESULTS: This study included 11 eligible randomized controlled trials involving 472 participants. Meta-analysis results demonstrated that exercise snacks interventions significantly increased absolute peak power output [MD = 16.53, 95%CI (2.93, 29.77), P = 0.02], maximal oxygen uptake [MD = 0.19, 95%CI (0.02, 0.36), P = 0.03], the number of repetitions in the 60-second sit-to-stand test [MD = 4.38, 95%CI (1.00, 7.77), P = 0.01], while significantly reducing body fat percentage [MD = -3.12, 95%CI (-5.51, -0.73), P = 0.01]. However, no statistically significant differences were observed in improving fatigue levels or BMI.

CONCLUSION: Among healthy and sub-healthy adults, exercise snacks interventions enhance cardiorespiratory endurance by increasing Wpeak and VO_2max. Concurrently, they improve functional movement capacity by increasing the number of 60-second sit-to-stand repetitions and reducing body fat percentage. As a feasible, convenient, and easily integrated exercise method, exercise snacks demonstrate significant potential for health promotion.

PMID:41950555 | DOI:10.1016/j.jnha.2026.100837

Arch Oral Biol. 2026 Mar 25;187:106576. doi: 10.1016/j.archoralbio.2026.106576. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the inhibition of Toll-like receptor 2 (TLR2) signaling in lipoteichoic acid-induced NF-κB activation and interleukin-6 (IL-6) production in primary human dental pulp stromal cells (DPSCs).

DESIGN: Primary human DPSCs were cultured with lipoteichoic acid from Staphylococcus aureus (LTA-SA; 10, 25, 50 µg/ml) for up to 72 h to assess time- and concentration-dependent IL-6 production. IL-6 secretion was quantified by ELISA, while cell counts were determined via cell counter. To evaluate TLR2-dependent signaling, cells were pre-incubated with the TLR2 inhibitor C29 (100 µM) prior to LTA-SA stimulation. IL6 gene expression was analyzed by RT-qPCR, and NF-κB nuclear translocation was assessed by Western blot analysis. Non-parametric statistical analyses were applied to compare all groups and time points (Mann-Whitney U test or Kruskal-Wallis test; α = 0.05).

RESULTS: LTA-SA stimulation induced a significant, time- and concentration-dependent increase in IL6 gene expression and IL-6 secretion, accompanied by enhanced NF-κB nuclear translocation. Inhibition of TLR2 with C29 reduced nuclear translocation of NF-κB, along with a decrease in IL6 gene expression and IL-6 secretion, exhibiting both time- and concentration-dependent effects.

CONCLUSIONS: LTA induces IL-6 production in DPSCs via TLR2-mediated activation of the canonical NF-κB pathway. Targeted modulation of TLR2 signaling may represent a potential strategy for controlling pulpal inflammation.

PMID:41950554 | DOI:10.1016/j.archoralbio.2026.106576

Eur J Obstet Gynecol Reprod Biol. 2026 Apr 5;322:115095. doi: 10.1016/j.ejogrb.2026.115095. Online ahead of print.

ABSTRACT

OBJECTIVE: Pelvic organ prolapse (POP) impairs quality of life in aging women. Vaginal hysterectomy (VH) is a standard approach for advanced POP, yet large single-center series are limited. We evaluated concomitant procedures and perioperative outcomes of VH and explored associations of age, parity, and concomitant adnexal or reconstructive surgery with perioperative measures.

STUDY DESIGN: This retrospective cohort included 416 patients who underwent VH for POP between 2017 and 2025. Demographics, prolapse stage, concomitant procedures, perioperative complications, length of hospital stay, perioperative hemoglobin change, and pathological/specimen characteristics were recorded. Subgroup analyses compared patients undergoing additional reconstructive and/or adnexal surgery. Statistical analyses included t-test/ANOVA and Spearman correlation, with p < 0.05 considered statistically significant.

RESULTS: Mean age was 62.6 ± 9.2 years and mean parity 3.2 ± 1.7. POP was stage 3 in 41.6% and stage 4 in 34.6%. Anterior colporrhaphy was performed in 69.7%. Apical suspension accompanied VH in 72.4% of cases, including McCall culdoplasty (52.4%) and sacrospinous fixation (20.2%). Increasing age was associated with higher prolapse stage (p = 0.033). Vaginal deliveries were associated with cystocele and rectocele (p = 0.027 and p = 0.028). Concomitant adnexal surgery was associated with longer hospitalization and lower postoperative hemoglobin (p < 0.001 and p = 0.03). Postoperative complications occurred in 1.4% and were associated with lower mean age (p = 0.038).

CONCLUSIONS: VH for advanced POP demonstrated favorable perioperative outcomes with a low complication rate. Age, parity, and concomitant procedures influenced perioperative measures, supporting VH with apical suspension as a reliable real-world surgical option.

PMID:41950546 | DOI:10.1016/j.ejogrb.2026.115095

J Am Soc Mass Spectrom. 2026 Apr 8. doi: 10.1021/jasms.5c00444. Online ahead of print.

ABSTRACT

Imidacloprid (IMI) is a widespread neonicotinoid insecticide of environmental concern because of its ecotoxicity and persistence. Tracing its commercial sources and environmental transformation is difficult with concentration-based approaches. We explored electrospray ionization Orbitrap isotope ratio mass spectrometry ((ESI) Orbitrap MS-Based Isotope Ratio Analysis) for compound- and fragment-specific stable isotope analysis of IMI at natural abundance. This approach enables direct measurement of ¹³C, ¹⁵N, ³⁷Cl, and multiple substituted isotopologue ratios. Experimental parameters were optimized to control sources of bias in isotopologue ratios. A dual-inlet bracketing protocol enabled normalization and drift correction. IMI from seven different commercial sources could be distinguished by their isotopic fingerprints. We demonstrate that principal component analysis (PCA) can exploit the expanded set of isotopic variables. Two PCAs with distinct variable sets were performed: a fragment-only, nonoverlapping isotopologue subset for source material attribution, and a combined molecular-average and fragment-level subset to maximize manufacturer discrimination. Alkaline hydrolysis (pH ≈ 12, 30 °C) based on compound-average δ¹³C and δ¹⁵N values measured by (ESI) Orbitrap MS-Based Isotope Ratio Analysis revealed significant carbon isotope fractionation (ε_C = -4.3 ± 1.4 ‰) and a statistically negligible nitrogen fractionation (ε_N = 0.6 ± 1.6 ‰), consistent with initial OH^– attack at the nitroimine carbon as the primary pathway. (ESI) Orbitrap MS-Based Isotope Ratio Analysis can elucidate transformation mechanisms in analytically challenging polar analytes. The chemometric approach of using MS¹/MS² data can be transferred to other (agro-)chemicals either to enhance isotopic discrimination or to discover patterns.

PMID:41950525 | DOI:10.1021/jasms.5c00444

JMIR Med Educ. 2026 Apr 8;12:e82136. doi: 10.2196/82136.

ABSTRACT

BACKGROUND: Virtual reality (VR) is increasingly used in medical education for training and examination purposes; yet, learners’ performance in VR-based assessments may be influenced by more than clinical competence alone. Immersive competence (IC) has been proposed as a relevant factor in VR-based performance assessment. While general IC captures application-independent VR interaction skills, domain-specific applications may require an additional construct, specific immersive competence (specific IC), reflecting context-dependent interaction proficiency.

OBJECTIVE: This study aimed to develop and examine the initial psychometric characteristics of a newly developed in situ checklist for assessing specific IC, to explore the relationship between specific and general IC as well as related human abilities and characteristics, and to capture preliminary associations between both IC measures and medical performance in a VR-based objective structured clinical examination (OSCE) station.

METHODS: In this observational follow-up study, 21 final-year medical students who had previously completed a curricular OSCE including a VR-based emergency medicine station were recruited. General IC was assessed using the VR competence app, and specific IC using a checklist embedded in the original VR simulation. Additional measures included self-reported technological affinity, spatial ability, and OSCE performance scores. Analyses focused on descriptive statistics and exploratory associations, including item difficulty, item-total correlations, and internal consistency for the specific IC checklist. Pearson r was used to examine associations among variables.

RESULTS: The final 13-item specific IC checklist demonstrated acceptable internal consistency for an early-stage instrument (Cronbach α=0.79) and balanced item difficulty (mean P 0.56, SD 0.28). Specific IC showed a strong exploratory association with general IC (r=0.56; P=.008) and with prior 3D application experience (r=0.57; P=.007), but no relevant association with spatial ability. Both general and specific IC showed borderline, moderate associations with VR-OSCE performance (r=0.41; P=.06 and r=0.37; P=.09, respectively), while neither was related to overall analog OSCE performance.

CONCLUSIONS: In this pilot sample, specific IC emerged as a psychometrically accessible construct aimed to capture context-sensitive VR interaction skills. The proposed in situ approach offers a feasible and scalable method to assess this construct within domain-specific VR applications. Although associations with medical performance were exploratory and limited by sample size, the findings suggest the relevance of IC as a potential source of construct-irrelevant variance in VR-based assessments and support further investigation in larger, confirmatory studies.

PMID:41950510 | DOI:10.2196/82136

JMIR Public Health Surveill. 2026 Apr 8;12:e81412. doi: 10.2196/81412.

ABSTRACT

BACKGROUND: Ambient ozone (O3) exposure has been found to be associated with gestational hypertension, which, in turn, increases the risk of term low birth weight (LBW). As such, gestational hypertension acts as a potential mechanism mediating restricted fetal growth; however, few epidemiological studies have quantified this specific mediation pathway.

OBJECTIVE: This study aims to examine whether gestational hypertension serves as a mediator of the association between prenatal O3 exposure and term LBW.

METHODS: We conducted a population-based cohort study using the Cheeloo Lifespan Electronic Health Research Data-library, including 3,394,739 singleton term live births in Shandong Province, China, from January 1, 2016, to December 31, 2022. We used high-resolution spatiotemporal models based on residential addresses for exposure assessment. In addition to term LBW, we examined term small for gestational age (SGA) to capture fetal growth restriction while accounting for gestational age at birth. Given the low prevalence of these outcomes, we used logistic regression models where odds ratios approximated relative risks. A 4-step mediation analysis using logistic regression was conducted, followed by a counterfactual-based causal mediation analysis, to test the mediating role of gestational hypertension.

RESULTS: The mean (SD) O3 concentration was 113.90 (13.03) μg m-3. Each IQR increase in O3 was positively associated with the risks of term LBW (relative risk 1.055, 95% CI 1.034-1.077) and term SGA (relative risk 1.037, 95% CI 1.026-1.048). Using the traditional approach, gestational hypertension mediated 19.94% of the risk for term LBW and 13.41% for term SGA. Under the counterfactual framework, the contribution rates were 38.82% (term LBW) and 19.96% (term SGA) when excluding exposure-mediator interaction, and 35.15% (term LBW) and 18.82% (term SGA) when accounting for such interaction.

CONCLUSIONS: Our findings showed that gestational hypertension was a significant mediator of the association between O3 exposure and risks of term LBW. Consequently, a multitiered strategy-encompassing stricter air quality standards, integrating O3 risk education into routine prenatal care, and taking proactive measures to minimize personal exposure-is essential to prevent potential adverse impacts on developing fetuses and mothers.

PMID:41950506 | DOI:10.2196/81412

JMIR Mhealth Uhealth. 2026 Apr 8;14:e56824. doi: 10.2196/56824.

ABSTRACT

BACKGROUND: Problematic social media use has been linked to reduced well-being and impulse control difficulties. While digital self-control apps show potential for reducing general app usage, they often lack customization, leading to limited effectiveness and increased user resistance. Their impact on problematic social media use remains uncertain.

OBJECTIVE: This study evaluates the effectiveness of the Wellspent app, a customizable mobile intervention app designed to promote self-regulated social media use by targeting user-defined problematic app use and offering tailored behavioral nudges.

METHODS: In a 3-week randomized controlled trial, 70 iPhone users (mean age 26.2, SD 5.6 years; 47/70, 67% female), regularly using at least 1 social media app, were randomly assigned to an intervention (n=35) or control group (n=35). The intervention group received personalized full-screen reminders with the option to quit or continue social media app use whenever an app session exceeded a self-defined time limit. Participants completed weekly online surveys measuring problematic social media use, problematic smartphone use, self-efficacy, and daily screen time on their most problematic app. Linear mixed models tested intervention effects.

RESULTS: While no significant reduction in problematic social media use or increase in self-efficacy was observed, the intervention group showed a significant reduction in daily screen time on their most problematic app by approximately 29 minutes (estimate=-29.35, SE 6.84, 95% CI -42.79 to -15.99; P<.001), and a significant decrease in perceived problematic smartphone use (estimate=-0.46, SE 0.18, 95% CI -0.80 to -0.11; P=.01).

CONCLUSIONS: The Wellspent app demonstrated short-term efficacy in reducing problematic smartphone use. By allowing users to tailor interventions to their personal goals, the app shows promise as a self-directed tool to support healthier digital habits. Further research should explore long-term effects and feature-specific impacts.

PMID:41950504 | DOI:10.2196/56824

Hepatology. 2026 Apr 8. doi: 10.1097/HEP.0000000000001765. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: OCE-205 is a mixed agonist-antagonist selective for the vasopressin 1a (V1a) receptor with no vasopressin 2 (V2) receptor activity. Safety and efficacy of OCE-205 were evaluated in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI).

METHODS: A randomized, double-blind, placebo-controlled, dose-ranging study was conducted at 23 North American centers. Patients received a continuous infusion of OCE-205 at 8, 15, 30 or 50 µg/hr or placebo. Primary endpoint was time to confirmed clinical improvement, defined as serum creatinine (sCr) <1.5 mg/dL, with at least an absolute reduction of ≥0.3 mg/dL, for 2 days. Following terlipressin’s approval, this study was stopped early due to lack of equipoise in conducting a placebo-controlled trial.

RESULTS: Baseline characteristics between OCE-205 (n=37) vs. placebo (n=10) groups were: sCr 2.6 vs 2.3 mg/dL, MELD 27.9 vs 25.8, alcohol-related cirrhosis 51.4% vs 60.0%. The primary endpoint was met in 48.6% vs. 30.0% (p=0.48 by Log-rank test and NS by Bayesian analysis). Bradycardia was the most common adverse event (21.6% vs 0%). Most events were asymptomatic, requiring no intervention. No new/unexpected safety findings, no events of ischemia, and no related events of respiratory failure occurred.

CONCLUSIONS: OCE-205 was well tolerated, with no evidence of excessive vasoconstriction or related events of ischemia or respiratory failure at any dose level. OCE-205 had a predictable, capped maximal efficacy that improved HRS-AKI in numerically more patients than placebo, though was underpowered for statistical significance. OCE-205 warrants additional investigation as a novel HRS therapy with a favorable benefit/risk profile.

PMID:41950496 | DOI:10.1097/HEP.0000000000001765

JMIR Serious Games. 2026 Apr 8;14:e72498. doi: 10.2196/72498.

ABSTRACT

BACKGROUND: Virtual reality (VR) technology has been increasingly explored in stroke rehabilitation due to its immersive and interactive features. However, considerable heterogeneity exists in intervention designs, study populations, and outcome measures, limiting the feasibility of conducting a systematic review.

OBJECTIVE: This scoping review aims to comprehensively map randomized controlled trials (RCTs) investigating the use of VR interventions in stroke rehabilitation, with particular focus on upper limb function, gait and balance, cognitive function, and quality of life.

METHODS: Following the Arksey and O’Malley framework and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review of RCTs published in databases from their inception to January 4, 2025. Seven databases were searched, including PubMed, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM. Studies were included if they met predefined eligibility criteria, including adult patients with stroke receiving VR-based rehabilitation and a randomized controlled trial design. Exclusion criteria included non-Chinese or non-English literature, literature with unavailable full text, studies with duplicate publication or data, and studies that were irrelevant to the research topic or did not incorporate VR technology in their intervention measures. Data extracted included intervention type, sample size, training frequency and duration, outcomes, and study setting. Due to significant heterogeneity across studies, a narrative synthesis approach was used. No formal risk of bias or quality appraisal was conducted.

RESULTS: Fifteen RCTs involving 804 patients with stroke were included. Intervention modalities varied significantly in terms of type, content, frequency, and duration. Nonimmersive VR (NIVR) interventions were more frequently applied in studies targeting upper limb function and gait training, while fully immersive VR (FIVR) was assessed in 2 head-mounted display (HMD)-based trials, whereas most studies used NIVR for upper-limb and gait-related outcomes. Many studies reported positive trends in motor function, cognitive performance, gait balance, and quality of life. However, findings were inconsistent, and not all outcomes reached statistical significance. Mild adverse events, such as fatigue or dizziness, were occasionally reported; however, no serious events occurred.

CONCLUSIONS: This scoping review outlines the research status of VR in stroke rehabilitation. VR may offer potential benefits; however, existing studies have limitations, including substantial heterogeneity in intervention protocols, limited long-term follow-up, and baseline imbalances in some trials. In addition, because this review did not include a formal quality or risk-of-bias assessment, the observed effects should be interpreted as preliminary signals rather than definitive evidence of efficacy, and the certainty of the evidence cannot be determined. Future research should standardize outcome measures, improve methodological rigor, and incorporate quality and risk-of-bias evaluation to strengthen the evidence base and support clinical implementation.

PMID:41950465 | DOI:10.2196/72498

Am J Public Health. 2026 May;116(5):594-595. doi: 10.2105/AJPH.2026.308478.

NO ABSTRACT

PMID:41950459 | DOI:10.2105/AJPH.2026.308478