Tag: nevin manimala

Cardiovasc Ther. 2026;2026(1):e6940329. doi: 10.1155/cdr/6940329.

ABSTRACT

BACKGROUND: Sedentary behavior has become a major global public health challenge and is closely associated with cardiovascular disease (CVD). Sedentary behavior not only increases the risk of various chronic diseases but also poses significant threats to cardiovascular health. Existing studies suggest that sedentary behavior is an independent risk factor for CVD, but the underlying mechanisms across different populations remain inadequately explored.

METHODS: This study analyzed data from 31,034 participants in the National Health and Nutrition Examination Survey (NHANES) to investigate the relationship between sedentary behavior and CVD. Standardized questionnaires were used to collect sociodemographic and health information. Statistical analyses, including weighted t-tests, forest plots, logistic regression, and restricted cubic spline regression, were employed to examine the effects of sedentary time on CVD and related influencing factors.

RESULTS: The findings indicated that prolonged sedentary time was significantly associated with an increased risk of CVD, particularly among individuals aged 60 and older (OR = 17.297, p < 0.001) Factors such as age, gender, and hyperlipidemia played a critical role in the relationship between sedentary behavior and CVD. Restricted cubic spline regression analysis revealed that CVD risk increased markedly after 250 min of sedentary time, with a pronounced rise after 750 min. Multivariate regression analysis also confirmed the negative impact of sedentary behavior on cardiovascular health.

CONCLUSION: Sedentary behavior is a significant independent risk factor for CVD, and reducing sedentary time is associated with a lower CVD risk. Enhancing public awareness of the hazards of sedentary behavior and implementing effective interventions, especially for the elderly, may contribute to improved cardiovascular health.

PMID:41937611 | DOI:10.1155/cdr/6940329

J Psychiatr Ment Health Nurs. 2026 Apr 6. doi: 10.1111/jpm.70127. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of art therapy in improving depressive and anxiety symptoms among adults with depression.

DESIGN: A systematic review and meta-analysis.

METHODS: Seven databases were searched from inception to November 14, 2025. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating art therapy for adults with clinically diagnosed or screened depression were included. Two reviewers independently performed study selection, data extraction and quality assessment using Cochrane Risk of Bias 2.0 (RoB 2.0) and the Joanna Briggs Institute (JBI) checklist. Standardized mean differences (SMDs) were pooled using random-effects models, with subgroup and sensitivity analyses conducted to explore heterogeneity.

RESULTS: Fourteen studies (861 participants) were included in the systematic review, and 13 contributed data to the meta-analysis. Art therapy produced a significant reduction in depressive symptoms compared with control conditions (SMD = -0.69, 95% CI: -1.04 to -0.35; z = 3.92, p < 0.001). Effects on anxiety symptoms were small and not statistically significant. Exploratory subgroup analyses suggested larger effects in older adults, interventions lasting > 6 weeks, story therapy, individual formats and community settings. However, substantial heterogeneity and the inclusion of trials at risk of bias warrant cautious interpretation. Sensitivity analyses indicated stable results across model specifications.

CONCLUSION: Art therapy appears to be a promising intervention for improving depressive symptoms among adults with depression. In contrast, the result regarding anxiety outcomes is limited, with only three studies contributing data. High-quality studies with large samples, multiple centres and long follow-up durations should be performed to further reliably assess the treatment effects.

TRIAL REGISTRATION: PROSPERO registration number: CRD420251229306.

PMID:41937601 | DOI:10.1111/jpm.70127

Chronobiol Int. 2026 Apr 6:1-14. doi: 10.1080/07420528.2026.2650828. Online ahead of print.

ABSTRACT

Delayed-onset muscle soreness can hinder athletic performance by impairing recovery processes. Adequate and restorative sleep plays a crucial role in regulating hormonal balance, cardiovascular adaptation, and muscle tissue repair. However, intense exercise often disturbs sleep quality, thereby prolonging recovery. This study aimed to investigate whether improving sleep quality through melatonin supplementation could indirectly influence recovery parameters, including flexibility, cardiovascular indices, and muscle damage biomarkers, in active athletes. Twenty-four male athletes (18-25 y) from multiple sports, including soccer, basketball, volleyball, and athletics, participated. Participants (N = 24) were randomly assigned to a Melatonin group (3 mg/d for 5 nights before sleep at 10.00 PM, n = 12) or a Placebo group (n = 12). All subjects performed 30 min of eccentric plyometric exercise. Sleep quality was monitored using Fitbit Charge 3 devices, which have been validated against polysomnography for field use. Blood samples were collected pre-exercise and at 24-, 48-, 72-, and 96-h post-exercise to determine CK, IL-6, TNF-α, LDH, MYO, and AST levels. Melatonin supplementation significantly improved total sleep duration, flexibility scores, and resting heart rate compared to placebo (p < 0.05). However, melatonin did not produce statistically significant effects on muscle damage biomarkers (CK, LDH, MYO, AST, IL-6, TNF-α). These findings indicate that melatonin primarily enhances sleep and may aid cardiovascular recovery, with limited direct influence on biochemical markers of muscle damage after acute eccentric overload exercise. Low-dose melatonin supplementation may serve as a supportive, non-pharmacological strategy to improve sleep quality in athletes. While it did not significantly reduce biochemical indicators of muscle damage and cardiovascular recovery, the improved sleep-related recovery suggests potential indirect benefits for overall post-exercise adaptation.

PMID:41937599 | DOI:10.1080/07420528.2026.2650828

Asian Spine J. 2026 Apr 6. doi: 10.31616/asj.2025.0356. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective, cross-sectional study.

PURPOSE: Injuries to the lumbar spine may alter the lumbar intervertebral space (LIVS). This study aimed to establish the LIVS Dictionary, a standardized anatomical reference system for LIVS, and to evaluate its ability to detect ligamentous injuries using sex-specific normative data.

OVERVIEW OF LITERATURE: This study presents the first computed tomography (CT)-based LIVS Dictionary from 457 asymptomatic subjects. It identifies sex-specific differences, age-linked degeneration patterns, and demonstrates its utility in detecting anterior ligament injuries, particularly among females.

METHODS: Enhanced whole-abdominal CT scans from 457 asymptomatic adults were retrospectively analyzed to construct the LIVS Dictionary. Seven anatomical regions encompassing 28 LIVS parameters were quantified using 3D Slicer. A validation cohort of 87 patients with five distinct types of lumbar fractures was included. Statistical analyses involved t -tests, Cohen’s d, uniform manifold approximation and projection clustering, and Elastic Net receiver operating characteristic (ROC) curve analysis with 95% confidence intervals (CIs).

RESULTS: Most LIVS parameters were significantly larger in males (25 of 28 parameters, p<0.05), particularly in the anterior regions. Age analysis revealed sex-specific degeneration patterns: males showed progressive LIVS reduction with age, whereas females exhibited localized decline after 80 years. Incidental anatomical variants included lumbarization in 5.25% and sacralization in 1.09% of the healthy cohort. Among fracture types, transverse process fractures produced the greatest LIVS alterations. The Elastic Net model demonstrated excellent predictive performance (area under the ROC curve=0.90; 95% CI, 0.88-0.92; accuracy=0.94).

CONCLUSIONS: Lumbar spine injuries produce quantifiable alterations in LIVS morphology. The LIVS Dictionary provides a validated framework for identifying these changes and captures sex-, age-, and fracture-related morphological variations with high diagnostic robustness. This framework establishes a foundation for clinical evaluation, biomechanical modeling, and forensic applications related to spinal stability.

PMID:41937573 | DOI:10.31616/asj.2025.0356

Addiction. 2026 Apr 6. doi: 10.1111/add.70411. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Cannabis use disorder (CUD) is a pressing public health concern in the United States, and understanding trends in prevalence requires considerations of how changes in measurement influence identification of CUD. Starting in 2021, the National Survey on Drug Use and Health (NSDUH) assessed CUD using all 11 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in their entire sample; before then, studies could use a nine-criteria DSM-5-proxy measure based on shared DSM-IV criteria. We aimed to identify sociodemographic characteristics associated with additionally identified CUD when using the full DSM-5 measure compared with the DSM-5-proxy measure.

DESIGN: Observational study using nationally representative data.

SETTING: United States.

PARTICIPANTS: 39 973 participants ages 12 + who reported past-year cannabis use in the 2021-2023 NSDUH (weighted N = 57 872 556).

MEASUREMENTS: Additionally identified mild, moderate, or severe CUD was defined as meeting 2-3, 4-5, or 6 + of the 11 DSM-5 criteria and not meeting the same thresholds with the nine DSM-5-proxy criteria. Multinomial logistic regression models compared characteristics of people with additionally identified mild (vs. none), moderate (vs. mild), and severe (vs. moderate) CUD. We also calculated the percentage of people meeting each of the 11 criteria who had additionally identified CUD.

FINDINGS: Among people who reported past-year cannabis use, 30.5% had DSM-5 CUD, including 7.9% with additionally identified mild CUD not previously identified using the DSM-5-proxy measure, 6.9% with additionally identified moderate CUD and 3.4% with additionally identified severe CUD. People who were younger (vs. 35-49); multiracial (vs. white); non-Hispanic American Indian or Alaska Native (vs. white); or publicly insured or uninsured (vs. privately insured only) were more likely to have additionally identified CUD and/or CUD severity. People who were older (vs. 35-49); Hispanic (vs. white); were non-Hispanic Asian, Native Hawaiian, or Pacific Islander (vs. white); reported female sex (vs. male); or had annual income greater than $75 000 (vs. <$20 000) were less likely to have additionally identified CUD and/or CUD severity. Additionally identified CUD was most common among those meeting “craving” (25.0%), “withdrawal” (20.3%), and “spending time” (14.8%) criteria.

CONCLUSIONS: The full Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) measure of cannabis use disorder (CUD) additionally identified CUD differentially across sociodemographic groups in the United States, compared with the DSM-5-proxy measure. Some groups (e.g., people younger than 35 years old, people with any public or no insurance, and people who are multi-racial or non-Hispanic American Indian or Alaska Native) may need more CUD-related services and support than previously expected.

PMID:41937566 | DOI:10.1111/add.70411

Clin J Pain. 2026 Apr 6. doi: 10.1097/AJP.0000000000001385. Online ahead of print.

ABSTRACT

OBJECTIVES: Dexmedetomidine is a short-term sedative used for peripheral nerve blockade and spinal anesthesia. This meta-analysis evaluated efficacy and safety of dexmedetomidine in TAP block in C-section.

METHODS: A systematic search across online databases comparing dexmedetomidine with local anesthetics to local anesthetics isolated in TAP block for women undergoing spinal anesthesia for cesarean section. Significance was defined at P<0.05 for odds ratios (OR), mean differences (MD), and standard mean differences (SMD). Heterogeneity weas evaluated using I² statistics. Twelve randomized controlled trials (RCTs) encompassing 799 patients were included.

RESULTS: Dexmedetomidine delayed the consumption of first analgesic (MD 3.69; [95% CI 2.93-4.45]; P<0.00001; I²=86%) in the postoperative period; decreased the amount of rescue intravenous tramadol consumption (MD -13.61; [95% CI -24.56–2.67]; P=0.01; I²=85%), the number of patients who required rescue analgesic (OR 0.25; [95% CI 0.13-0.49]; P<0.00001; I²=42%) and the VAS scores at 6h (MD -1.48; [95% CI -1.65–1.30]; P<0.0001; I²=70%), at 12h (MD -0.92; [95% CI -1.60–0.24]; P=0.008; I²=90%) and at 24h (MD -0.50; [95% CI -0.93–0.08]; P=0.02; I²=92%). When patient satisfaction score was analyzed, there was also a significant difference between groups (SMD 1.07; [95% CI 0.76-1.39]; P<0.00001; I²=0%).

DISCUSSION: Dexmedetomidine with local anesthetics was associated with a delay in consumption of the first analgesic in the postoperative period, decrease in the amount of rescue intravenous tramadol and in the VAS scores at 6, 12 and 24 hours. However, the GRADE assessment of the quality of evidence was ‘low’ due to the high risk of bias and heterogeneity.

PMID:41937563 | DOI:10.1097/AJP.0000000000001385

Plant J. 2026 Apr;126(1):e70851. doi: 10.1111/tpj.70851.

ABSTRACT

1-Aminocyclopropane-1-carboxylic acid synthase (ACS) is a central and rate-limiting enzyme in ethylene biosynthesis, but the regulation of ACS in response to endogenous signals and environmental stimuli remains largely unknown, especially in fruit crops such as bananas. In this study, we used various methods, including genome-wide identification, molecular dynamics, comparative genomics, DNase-seq, DAP-seq, RNA-seq, and molecular assays, to elucidate the mechanism by which the transcription factor MaMYB73 regulates the expression of the ethylene biosynthesis-related gene MaACS1. Fourteen MaACS genes were identified in banana, among which MaACS1 plays crucial roles in ethylene biosynthesis. Molecular dynamics showed that MaACS1 binds S-adenosyl-L-methionine (SAM) at residue R220. Comparative genomics revealed that MaACS1 has three orthologs in the tomato genome (SlACS2, SlACS4, and SlACS1B). This orthogroup underwent a statistically significant expansion event along the evolutionary lineage leading to tomato, correlating with its increased ethylene production compared with that of banana. DNase-seq and DAP-seq revealed that MaMYB73 directly binds to the MaACS1 promoter. The overexpression of MaMYB73 in both banana and tomato resulted in reduced expression of MaACS1 and its homologs, respectively, leading to delayed ethylene production. Conversely, silencing MaMYB73 through virus-induced gene silencing (VIGS) significantly increased MaACS1 expression and ethylene production in banana fruit. Furthermore, the RING-H2-type E3 ubiquitin ligase MaRHA2A1, an ethylene accelerator, targets MaMYB73 for ubiquitination and subsequent degradation via the 26S proteasome pathway. Transient overexpression of MaRHA2A1 in banana increased MaACS1 expression and ethylene levels possibly by reducing the accumulation of MaMYB73, whereas silencing of MaRHA2A1 had the opposite effect. These findings provide new insights into the regulatory mechanisms controlling ethylene biosynthesis during banana fruit ripening and establish a new strategy for characterizing the transcriptional regulators of ethylene biosynthesis using various bioinformatics technologies.

PMID:41937552 | DOI:10.1111/tpj.70851

J Physician Assist Educ. 2025 Dec 8. doi: 10.1097/JPA.0000000000000731. Online ahead of print.

ABSTRACT

INTRODUCTION: Identifying predictors of success on the Physician Assistant National Certifying Examination (PANCE) is critical for physician assistant (PA) programs aiming to improve student outcomes. While preadmission metrics are often emphasized, the influence of academic performance during the PA program remains a focus of ongoing investigation. This study examines the relative contributions of preadmission variables, selected demographic factors, and didactic and clinical academic performance in predicting PANCE outcomes.

METHODS: This is a retrospective cohort study of 3 cohorts of PA students (2022-2024), assessing preadmission metrics and performance during the didactic phase and clinical year for associations with PANCE scores using linear regression, Mann-Whitney U, and Kruskal-Wallis tests, with significance set at P < .05.

RESULTS: No statistically significant associations were observed between PANCE scores and preadmission factors, including prematriculation course grades, undergraduate cumulative and science GPAs, patient care hours, or demographic variables such as gender, age, and geographic background. In contrast, didactic and clinical year GPAs, as well as performance on summative I and II exams and the end of curriculum exams, were all strongly and positively correlated with PANCE outcomes (P < .0001).

DISCUSSION: The findings suggest that both the didactic and clinical phases, along with summative assessments, are the strongest predictors of first-time PANCE success. These results underscore the importance of a rigorous curriculum and comprehensive internal assessments to prepare students for certification. Ongoing academic monitoring helps PA programs proactively identify and support students at risk of underperformance on the PANCE.

PMID:41937534 | DOI:10.1097/JPA.0000000000000731

J Appl Gerontol. 2026 Apr 6:7334648261439431. doi: 10.1177/07334648261439431. Online ahead of print.

ABSTRACT

Climate change has intensified environmental conditions that may affect respiratory comfort and overall well-being, particularly among older adults. Empirical evidence on respiratory symptoms and quality of life in later life across diverse climatic contexts remains limited. A rapid online survey was conducted from July to September 2024 among 1,585 adults aged ≥60 years from 14 provinces. Respiratory symptoms were assessed using the WURSS-24, and quality of life using the WHOQOL. Descriptive statistics were applied. Mild to moderate respiratory symptoms were commonly reported in daily life. Higher respiratory symptom burden and lower quality of life were descriptively observed with advancing age, no employment history, and residence in hotter, drier zones. Differences by sex and educational background were minimal, and subgroup patterns in respiratory symptoms were descriptively compared with quality-of-life domain scores. Respiratory symptoms among older adults in Indonesia were commonly reported and descriptively presented alongside perceived quality-of-life scores.

PMID:41937508 | DOI:10.1177/07334648261439431

J Dent Educ. 2026 Apr 6. doi: 10.1002/jdd.70215. Online ahead of print.

ABSTRACT

BACKGROUND: The advent of digital tools impacted all fields, especially dentistry by improving efficiency, the development of an index recording application is warranted to enable better data storage and data safety, reduce workload and streamline the process compared to conventional methods, thus the aim of the study is to evaluate the effectiveness of an application-based dental index recorder on user experience, acceptance, adoption attitude, and perception among dental students 3 months post-intervention.

METHODS: An interventional study was conducted among 150 dental students over a period of 3 months. The development of the application was carried out using the ADDIE model. Evaluation of the application was performed using pre-validated user experience and acceptance questionnaire after 3-month post-intervention and a customized validated attitude and perception questionnaire administered at baseline and 3-month post-intervention. The adoption of the application was evaluated through a customized validated questionnaire administered after 3 months. Descriptive statistics were calculated followed by chi-square and paired t-test were applied.

RESULTS: High user experience scores were recorded for attractiveness (2.7 ± 0.2), efficiency (2.5 ± 0.3), and novelty (2.9 ± 0.3), along with high acceptance and adoption with 85.3% integrating the application into academic practice. After 3 months post-intervention, a statistically significant positive change in attitude and perception was observed, with mean differences of 0.8 ± 0.3 and 0.3 ± 0.3, respectively, towards the application-based dental index recorder (p < 0.001).

CONCLUSION: High user experience, acceptance and adoption score along with positive attitude and perception among dental students towards the application suggest that it could be used in place of conventional index recording methods.

PMID:41937500 | DOI:10.1002/jdd.70215