Category: Nevin Manimala

Front Public Health. 2026 Aug 3;14:1905069. doi: 10.3389/fpubh.2026.1905069. eCollection 2026.

ABSTRACT

BACKGROUND: Children’s sedentary, lack of activities and low attention in class are common problems in global public health and education. Long-term sedentary will reduce children’s moderate-to-vigorous physical activity (MVPA), damage attention and executive function, and be detrimental to physical and mental health and academic performance. This paper explores the intervention function of structured active break.

METHODS: In this study, 1,248 students from grades 1-6 were enrolled in a stratified cluster randomized controlled trial, with individual classes defined as randomization and clustering correction units and grouped according to grade, gender and BMI. The intervention group had a 5-min structured in-class active break, while the control group maintained routine work and rest. The intervention period was 12 weeks. Activity data were collected by ActiGraph triaxial accelerometer, and concentration was evaluated by momentary time sampling and cancellation test. Generalized Estimating Equations (GEE) was used to correct the clustering effect, and 95%CI, Cohen’s d and partial η² were reported. The test level was α = 0.05, and Bonferroni multiple comparison correction was used for subgroup analysis.

RESULTS: After the intervention, the MVPA and light physical activity (LPA) in the intervention group increased by 18.6 min and 27.4 min, respectively, and the sedentary behavior duration decreased by 36.8 min, and the differences in various indexes and concentration related indexes were extremely significant compared with those in the control group (P < 0.001). Stratified analysis showed that children with lower grades, overweight and weak baseline concentration benefited more from intervention, and there was a significant three-way interaction effect (corrected P < 0.01), but there was no statistical difference between gender subgroups.

CONCLUSION: Short-term structured active break in class can improve children’s activity, reduce sedentary, and improve their concentration, which has a significant effect on junior, obese and attention-deficit students. This study is limited by a single-site sample, short-term follow-up, and a lack of physiological biomarker measurements, which restricts the generalizability of its conclusions. The related neural mechanism is still theoretical speculation and needs long-term multi-center research to prove it. This low-cost intervention can improve school-based health outcomes and classroom learning efficiency, and provide empirical evidence.

PMID:42609440 | PMC:PMC13478256 | DOI:10.3389/fpubh.2026.1905069

Front Behav Neurosci. 2026 Aug 3;20:1797790. doi: 10.3389/fnbeh.2026.1797790. eCollection 2026.

ABSTRACT

Romantic love lacks a mechanistic, testable evolutionary account. Prior work notes parallels with mother-infant bonding but leaves the genetic architecture and falsifiable predictions unspecified. We argue that romantic love evolved not through the evolution of new “love genes,” but by altering the regulation of existing genes: changing when, where, and under what physiological conditions these genes are active. This regulatory co-option framework generates several falsifiable predictions: (1) a shared genetic basis between maternal bonding and romantic love, (2) the involvement of non-coding, regulatory DNA regions in the brain, (3) a largely shared genetic architecture between the sexes, with differences in gene expression, and (4) genetic signals localized to specific brain circuits. We outline specific genomic and statistical methods to test these predictions, establishing clear criteria that would support or refute our hypothesis. This work shifts the study of romantic love’s evolution from analogy to a program of empirical inquiry and hopes to shed light on how social monogamy entered the Homo sapiens lineage. Key challenges include the lack of high quality meta-analytic fMRI evidence of romantic love and the scarcity of detailed data from relevant human brain circuits.

PMID:42609431 | PMC:PMC13478075 | DOI:10.3389/fnbeh.2026.1797790

Front Public Health. 2026 Aug 3;14:1896815. doi: 10.3389/fpubh.2026.1896815. eCollection 2026.

ABSTRACT

OBJECTIVE: To systematically evaluate the application effect of flipped classroom (FC) teaching mode in preventive medicine courses in Chinese medical colleges and universities.

METHODS: A systematic search was conducted in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), etc. to search for reports on the FC teaching model in preventive medicine courses. A quantitative system evaluation was conducted to assess the teaching effectiveness of FC with multiple indicators such as exam score, learning interest, and self-learning and thinking abilities.

RESULTS: A total of 28 articles were included, including 2,135 students in the flipped classroom group and 2,259 students in the LBL group. It showed that compared with the lecture-based learning (LBL) group, the FC can significantly improve students’ exam scores for both theoretical and practical components, their quantitatively synthesized SMDs were 0.99 (95% CI: 0.65-1.33) and 0.50 (95% CI: 0.30-0.70), respectively. Meanwhile, learning interest (RR = 1.42, 95%CI:1.33-1.53), independent learning and thinking ability (RR = 1.51, 95%CI: 1.31-1.73), cooperation and communication skills (RR = 1.60, 95%CI: 1.28-2.01), problem analysis and solving ability (RR = 1.47, 95%CI: 1.13-1.91), and teacher-student interaction (RR = 1.35, 95%CI: 1.10-1.66), the differences are statistically significant (p < 0.05).

CONCLUSION: The FC teaching model has shown significant advantages in the teaching of preventive medicine courses in Chinese higher medical colleges. In view of this, schools can reasonably apply it in relevant course teaching according to resources such as faculty and facilities.

PMID:42609425 | PMC:PMC13478085 | DOI:10.3389/fpubh.2026.1896815

Front Psychol. 2026 Aug 3;17:1878259. doi: 10.3389/fpsyg.2026.1878259. eCollection 2026.

ABSTRACT

INRODUCTION: Loneliness is a common and universal human experience associated with adverse psychological outcomes. Therefore, identifying psychological factors that reduce loneliness and strengthen individuals’ coping capacity may contribute to the development of more effective psychological interventions.

METHODS: The primary aim of this study was to examine the associations among self-efficacy, psychological flexibility, and loneliness, with particular emphasis on the indirect association between self-efficacy and perceived loneliness through psychological flexibility in a cross-sectional model. Data were collected using a Personal Information Form, the SELSA-S Social and Emotional Loneliness Scale, the Psychological Flexibility Scale, and the Self-Efficacy Scale. Pearson product-moment correlation analysis was conducted to examine the associations among the variables, and regression analysis was performed to examine the associations between self-efficacy, perceived loneliness, and psychological flexibility. The bootstrapping mediation analysis using the PROCESS macro (Model 4, 5000 bootstrap resamples) was conducted to examine the indirect association between self-efficacy and perceived loneliness through psychological flexibility. The sample consisted of 412 young adults recruited through convenience sampling.

RESULTS: The findings indicated that self-efficacy was positively associated with psychological flexibility and negatively associated with perceived loneliness, whereas psychological flexibility was negatively associated with perceived loneliness. Furthermore, a statistically significant indirect association between self-efficacy and perceived loneliness through psychological flexibility was observed in the cross-sectional model, whereas the direct association was not statistically significant.

DISCUSSION: These findings suggest that psychological flexibility may be relevant to the association between self-efficacy and perceived loneliness. However, given the cross-sectional design and convenience sampling, the findings should not be interpreted as evidence of causal mediation.

PMID:42609416 | PMC:PMC13478243 | DOI:10.3389/fpsyg.2026.1878259

Front Public Health. 2026 Aug 3;14:1836259. doi: 10.3389/fpubh.2026.1836259. eCollection 2026.

ABSTRACT

BACKGROUND: Menopause is a significant life transition during which women experience both physical and psychological changes. Aging anxiety has been identified as a key psychological factor that may negatively affect menopause-specific quality of life. However, the mediating roles of self-efficacy and self-acceptance in the relationship between aging anxiety and quality of life have not been sufficiently examined.

OBJECTIVE: This study aimed to examine the parallel mediating roles of self-efficacy and self-acceptance in the relationship between aging anxiety and menopause-specific quality of life among women experiencing menopausal symptoms.

METHODS: This study used secondary data from 114 women experiencing menopausal symptoms (N = 114). Aging anxiety was treated as the independent variable, self-efficacy and self-acceptance as mediators, and menopause-specific quality of life (MENQOL) as the dependent variable. A parallel mediation analysis with 5,000 bootstrap samples was conducted.

RESULTS: Aging anxiety showed a significant direct effect on menopause-specific quality of life (B = 1.40, p < 0.001). The total indirect effect through self-efficacy and self-acceptance was statistically significant (B = 0.36, 95% CI [0.03, 0.71]). However, the specific indirect effects through self-efficacy and self-acceptance were not statistically significant, as their confidence intervals included zero.

CONCLUSION: These findings suggest that aging anxiety may influence menopause-specific quality of life both directly and indirectly through the combined effects of self-efficacy and self-acceptance. Self-efficacy and self-acceptance may operate jointly rather than independently as mediators in this relationship. Therefore, interventions aimed at reducing aging anxiety and strengthening psychological resources may be beneficial for improving quality of life among women experiencing menopausal symptoms.

PMID:42609397 | PMC:PMC13477981 | DOI:10.3389/fpubh.2026.1836259

Front Public Health. 2026 Aug 3;14:1854301. doi: 10.3389/fpubh.2026.1854301. eCollection 2026.

ABSTRACT

INTRODUCTION: Childhood stunting remains a critical indicator of chronic undernutrition and a major barrier to achieving Sustainable Development Goals 1 and 2. Despite gradual improvements, substantial geographic disparities in stunting risk persist across India. This study characterised the spatial and temporal heterogeneity of childhood stunting using harmonized district-level data from NFHS-4 (2015-16) and NFHS-5 (2019-21).

METHODS: A Bayesian spatial geo-additive logistic regression model was applied to 482,960 children aged 0-59 months from 575 harmonized districts. The framework incorporated district-level BYM2 spatial random effects, district-specific survey-round interaction effects, and RW2 smoothers for child age and maternal BMI, estimated using Integrated Nested Laplace Approximation (INLA).

RESULTS: The spatial interaction model demonstrated substantially improved fit over the non-spatial model (ΔWAIC = 4,105.2), with a high estimated spatial fraction (φ = 0.983; 95% CrI: 0.938-0.999), indicating that most residual district-level variation was spatially structured. Model predictions showed strong agreement with weighted survey prevalence estimates (Pearson r = 0.975; R ² = 0.950). After accounting for district-specific temporal interactions, there was no evidence of a uniform national change in stunting risk between survey rounds (AOR = 0.986; 95% CrI: 0.960-1.013), with substantial heterogeneity in district-level temporal trajectories. Stunting risk peaked between 18 and 24 months of age and was elevated among children of severely undernourished mothers. Based on 95% posterior credible intervals of district-specific survey-round interaction effects, 59 districts demonstrated credible improvement, 35 demonstrated credible worsening, and 481 showed no credible evidence of change. A joint dOR-prevalence framework identified 213 districts (37.0%) as highest-priority areas, combining elevated adjusted district-level risk with high absolute stunting burden.

DISCUSSION: These findings demonstrate that childhood stunting in India remains strongly patterned by geography, with temporal changes varying substantially across districts. Geographically targeted and maternal-focused interventions will be essential for achieving equitable reductions in stunting and accelerating progress toward national nutrition goals.

PMID:42609395 | PMC:PMC13478098 | DOI:10.3389/fpubh.2026.1854301

Front Pharmacol. 2026 Aug 3;17:1757937. doi: 10.3389/fphar.2026.1757937. eCollection 2026.

ABSTRACT

OBJECTIVE: To compare the clinical outcomes associated with piperacillin-tazobactam (PIP-TAZ) versus cefotaxime-tazobactam (CTX-TAZ) in elderly patients with lower respiratory tract infection (LRTI).

METHODS: A total of 92 elderly patients with respiratory tract infection from March 2024 to April 2025 were selected as the subjects and divided into two groups of 46 cases in each group according to different treatment drugs. The control group was treated with tazobactam sodium/cefotaxime sodium, and the observation group was treated with piperacillin sodium for injection. The effects of the two groups were evaluated after 2 weeks of treatment. The blood gas level, inflammatory factors, lung function and drug safety were compared between the two groups.

RESULTS: Both groups showed significant improvements in arterial blood gases after treatment. Patients receiving PIP-TAZ exhibited a significantly greater increase in PaO2 and a greater reduction in PaCO2 compared to those receiving CTX-TAZ (both P < 0.05). Inflammatory markers (PCT, WBC, CRP) decreased, and pulmonary function indices (PEF, FVC, FEV1) increased significantly in both groups, with numerically greater improvements in the PIP-TAZ group (all P < 0.05, unadjusted). There was no statistical difference in drug safety between the two groups (P > 0.05).

CONCLUSION: In this comparative study, both piperacillin-tazobactam and cefotaxime-tazobactam demonstrated clinical effectiveness in improving objective physiological and inflammatory parameters in elderly patients with LRTIs. In this non-randomized comparison, the piperacillin-tazobactam regimen was associated with statistically significant, but unadjusted, differences favoring greater improvements in arterial blood gases (PaO2 and PaCO2), reductions in inflammatory biomarkers (PCT, WBC, CRP), and enhancements in lung function indices (PEF, FVC, FEV1) after 2 weeks of treatment compared to the cefotaxime-tazobactam regimen. These observed differences should be considered exploratory. Both treatments exhibited a comparable and acceptable safety profile in this cohort. However, these findings should be interpreted in light of the study’s non-randomized design, heterogeneous infection types, and the inherent differences between the antibiotic regimens. Further large-scale, randomized controlled trials with microbiological confirmation are warranted to validate these observations and define the optimal empiric antibiotic strategy in this vulnerable population.

PMID:42609393 | PMC:PMC13477961 | DOI:10.3389/fphar.2026.1757937

Front Aging. 2026 Aug 3;7:1793208. doi: 10.3389/fragi.2026.1793208. eCollection 2026.

ABSTRACT

INTRODUCTION: Nursing home residents show high sedentary behavior and limited physical functioning, while structural constraints hinder sustainable prevention. This study examined how group-based physical exercise and environmental interventions, such as activity-promoting materials and interior design, can be integrated into everyday care to promote a physical activity-promoting culture in nursing homes and identified key organizational and individual determinants of sustainable implementation.

METHODS: PROGRESS was a participatory, cluster-randomized cross-over trial conducted in seven nursing homes in the Münster area in Germany. Residents received two of four guided or non-guided exercise (n = 62) and/or environmental interventions (e.g., activity posters, a seated bike ergometer, walking brochures/routes; n = 65). Data from attendance logs, participatory workshops, and a follow-up questionnaire at t4 (the fourth and final measurement time point, approximately 50 weeks after baseline assessment; n = 73) were analyzed using descriptive statistics and structured content analysis for open-ended feedback. Based on these findings, the PROGRESS pyramid was developed as a framework for sustainable implementation of physical activity into everyday care.

RESULTS: Of the 73 participants, 90.4% attended at least one guided intervention session. Participation was highest in the exercise intervention, with most residents reporting weekly engagement. In contrast, engagement with environmental interventions was more variable and strongly dependent on staff support, with 63.0% of residents reporting no independent use of physical activity opportunities. Comparisons between self-reported participation and attendance records revealed substantial discrepancies, particularly for environmental interventions. Overall satisfaction with the project was high (mean = 2.7 ± 2.5 on a 0 = happy to 10 = angry scale). Most participants supported continuation of the interventions (86.0%), and 64.0% reported perceived personal benefits. Organizational and individual determinants jointly shaped participation.

CONCLUSION: In order to promote physical activity and functioning sustainably in nursing homes, it is necessary to address organizational conditions and individual needs in a coordinated manner. The PROGRESS pyramid translates these findings into a practical framework comprising organizational and communicational foundations, resident participation, education, and staff qualification to guide the long-term integration of exercise and environmental interventions into daily routine.

PMID:42609378 | PMC:PMC13478141 | DOI:10.3389/fragi.2026.1793208

Front Psychiatry. 2026 Aug 3;17:1889186. doi: 10.3389/fpsyt.2026.1889186. eCollection 2026.

ABSTRACT

INTRODUCTION: Postpartum depression is a common mental health condition after childbirth that can adversely affect maternal well-being, social functioning, and the mother-infant relationship. Although pharmacotherapy, psychotherapy, and exercise rehabilitation are available, current evidence is derived mainly from pairwise comparisons, leaving the relative efficacy of different exercise interventions and the certainty of comparative evidence unclear. This study therefore conducted a systematic review and network meta-analysis to compare the effects of different exercise rehabilitation interventions on postpartum depression and to evaluate the certainty of the evidence for clinical decision-making and exercise prescription.

METHODS: This systematic review and network meta-analysis was conducted according to a prespecified protocol. PubMed, Embase, the Cochrane Library, and Web of Science were systematically searched from inception to March 1, 2026. Randomized controlled trials involving postpartum women were eligible for inclusion. Interventions were classified as active control (AC), exercise combined with other interventions (E+CI), lifestyle physical activity promotion (LPA), mind-body exercise (MBE), passive control (PC), pelvic floor muscle training (PFMT), resistance training (RT), and structured aerobic exercise (SAE). The primary outcome was postpartum depression score treated as a continuous variable. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A frequentist random-effects network meta-analysis was conducted to synthesize direct and indirect evidence, with results expressed as standardized mean differences (SMDs) and 95% confidence intervals (CIs). Treatments were ranked using the surface under the cumulative ranking curve (SUCRA), the probability of being the best treatment, and mean rank. The certainty of evidence was evaluated using Confidence in Network Meta-Analysis (CINeMA) and Grading of Recommendations Assessment, Development and Evaluation (GRADE).

RESULTS: A total of 23 randomized controlled trials involving 2,752 postpartum women and 8 intervention/control nodes were included. Most studies were judged as having some concerns, and a few were rated as high risk of bias. No statistically significant global inconsistency was identified. For the primary outcome, SAE significantly reduced postpartum depression scores compared with both passive control and active control, showing the clearest statistically supported comparative effects. MBE showed favorable point estimates and ranking-based performance; however, its key comparisons with passive and active control did not reach statistical significance. Subgroup analyses suggested that MBE may be more favorable among postpartum women with baseline depression, whereas SAE may be more favorable among women without baseline depression who were considered high-risk or included in preventive samples. Sensitivity analyses suggested that SAE was relatively robust, whereas MBE was more sensitive to the influence of individual studies. Overall, the certainty of evidence was low to very low.

CONCLUSION: Among postpartum women, SAE showed the most consistent statistically significant advantages in key comparisons and demonstrated greater robustness in sensitivity analyses. MBE also appeared promising based on favorable point estimates and ranking-based results, but its main comparisons with passive and active control were not statistically significant and should not be interpreted as definitive evidence of superiority. Therefore, current evidence suggests that SAE has the clearest comparative support, while MBE remains a potentially beneficial intervention that requires further confirmation. However, the available evidence is limited by risk of bias, small sample sizes, imprecision, and low overall certainty. Further high-quality randomized controlled trials with larger samples, head-to-head comparisons, and standardized outcome reporting are required to confirm the relative efficacy of different exercise rehabilitation interventions.

SYSTEMATIC REVIEW: https://www.crd.york.ac.uk/PROSPERO/, identfier CRD420261352226.

PMID:42609368 | PMC:PMC13478091 | DOI:10.3389/fpsyt.2026.1889186

Front Oncol. 2026 Aug 3;16:1858110. doi: 10.3389/fonc.2026.1858110. eCollection 2026.

ABSTRACT

PURPOSE: This study aimed to evaluate whether evidence-based nursing interventions were associated with clinical outcomes in patients with leukemia undergoing chemotherapy and to support the development of optimized nursing strategies for hematologic oncology patients.

METHODS: This observational, single-center retrospective cohort study was conducted in the Pingyang Hospital Affiliated to Wenzhou Medical University, and was reported in accordance with the STROBE statement for observational studies. Adult patients with acute leukemia who underwent chemotherapy between February 2022 and February 2025 were screened using retrospective consecutive sampling according to predefined inclusion and exclusion criteria. Patients were classified according to the nursing model documented in electronic medical records: the conventional nursing group (n = 86) included patients treated from February 2022 to June 2023, when conventional nursing was the routine departmental nursing model, whereas the evidence-based nursing group (n = 91) included patients treated from July 2023 to February 2025, after a department-level evidence-based nursing pathway had been adopted in routine clinical practice. No patients were prospectively allocated to nursing interventions for the purpose of this study. Chemotherapy-related complications and SAS, SDS, ARMS, and SF-36 scores were extracted from medical records and routine nursing assessments. Separate binary logistic regression models were used to examine factors associated with infection, nausea/vomiting, and oral mucositis.

RESULTS: Compared with the Conventional group, the evidence-based group had lower incidences of infection (25.27% vs 41.86%, P = 0.019), nausea/vomiting (39.56% vs 65.12%, P < 0.001), and oral mucositis (17.58% vs 44.19%, P < 0.001). No significant between-group differences were observed for bleeding, bone marrow suppression, or phlebitis. Post-intervention SAS, SDS, and ARMS scores were lower in the evidence-based group, whereas SF-36 scores were statistically higher; however, the median between-group difference in SF-36 was modest (51.00 vs 47.50). In multivariable models, evidence-based nursing was associated with lower odds of infection (OR = 0.49, 95% CI: 0.25-0.96), nausea/vomiting (OR = 0.38, 95% CI: 0.20-0.73), and oral mucositis (OR = 0.31, 95% CI: 0.15-0.63).

CONCLUSION: Compared with conventional care, evidence-based nursing was associated with lower rates of selected chemotherapy-related complications, lower anxiety and depression scores, better treatment adherence, and a modest increase in SF-36 scores among leukemia patients undergoing chemotherapy. Because this was a single-center retrospective before-after study, these findings should be interpreted as associations rather than definitive causal effects. Patients with poor ECOG status, abnormal WBC counts, or repeated chemotherapy cycles may require more intensive risk assessment and stratified nursing management.

PMID:42609355 | PMC:PMC13477912 | DOI:10.3389/fonc.2026.1858110