Journal of Advanced Biomedical Sciences

Association between Anti-Citrullinated Peptide Antibodies (ACPA) Levels and Disease Severity in Patients with Rheumatoid Arthritis

2026-02-01T07:47:07+00:00

Background & Objectives: This case–control study was conducted to assess the diagnostic accuracy of serum anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA) and to determine their correlation with disease activity, as measured by the Disease Activity Score in 28 joints using C-reactive protein (DAS28- CRP).

Materials & Methods: A total of 70 patients with RA (85.7% female; mean age = 55.7 ± 11.73 years) and 70 age- and sex-matched healthy controls were included. Serum anti-CCP levels were measured using an enzyme-linked immunosorbent assay (ELISA), and disease activity was evaluated based on DAS28-CRP scores. Pearson’s correlation coefficient was applied to assess the relationship between anti-CCP levels and RA disease activity.

Results: Anti-CCP exhibited a sensitivity of 61.4% and a specificity of 98.6% for the diagnosis of RA. The mean serum anti-CCP concentration was significantly elevated in RA patients (220.2 ± 27.5 IU/mL) compared with controls (1.57 ± 0.52 IU/mL; p < 0.001). However, no statistically significant correlation was observed between anti-CCP levels and disease activity as determined by DAS28-CRP (p = 0.4).

Conclusion: Anti-CCP is a highly specific serological biomarker for the diagnosis of RA but does not demonstrate a significant association with disease activity as measured by DAS28-CRP. Further large-scale, longitudinal investigations are warranted to elucidate its potential role in predicting long-term joint destruction and disease progression.

Cognitive Hybridization: Redefining Human Identity at the Interface of Neuroscience and Artificial Intelligence: A Narrative Review

2026-02-01T07:47:06+00:00

Background & Objective: The convergence of human cognition and artificial intelligence (AI) is reshaping cognitive identity and challenging traditional understandings of consciousness, agency, and selfhood. This narrative review introduces a conceptual three-stage model of cognitive hybridization, comprising Simulation, Integration, and Co-Evolution, to examine the dynamics of human-AI interaction and its neuroethical implications.

Materials & Methods: Interdisciplinary evidence from cognitive neuroscience, AI research, and neuroethics was synthesized by drawing on studies published between 2000 and 2025 in PubMed, Scopus, and Web of Science. The review focused on brain-computer interfaces (BCIs), mechanisms of neural plasticity, and the cognitive capacities of large language models (LLMs).

Results: In the Simulation stage, LLMs replicate selected cognitive operations such as language processing, although they lack any biological substrates, including hippocampal encoding and network-level neural dynamics. The Integration stage involves reciprocal interactions between the brain and AI, where BCIs facilitate emergent forms of shared agency mediated through cortical and basal ganglia pathways. The Co-Evolution stage reflects bidirectional adaptive processes that gradually reshape cognitive functions across both developing and aging brains. Key neuroethical considerations include autonomy, cognitive justice, and the protection of neural data and cognitive privacy.

Conclusion: This model highlights the urgent need for updated theoretical and ethical frameworks that can guide human-AI co-evolution and promote equitable and safe cognitive enhancement. The proposed framework offers a structured foundation for future interdisciplinary inquiry in neuroethics and cognitive augmentation.

The Role of Ultrasonography in Polycystic Ovarian Syndrome Diagnosis and its Psychological Impact on Women’s Well-Being in the Faisalabad Region, Pakistan

2026-02-01T07:47:05+00:00

Background & Objective: Polycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrine disorders in women and is associated with diverse reproductive and metabolic complications. Beyond physical manifestations such as menstrual irregularities, weight gain, hirsutism, and hair loss, many women also experience emotional challenges, including stress, depression, and reduced self-esteem. This study aimed to examine the psychological implications of PCOS and to identify supportive measures that may enhance comprehensive patient care.

Materials & Methods: A community-based survey was conducted among women diagnosed with PCOS. Participants provided detailed information on their symptoms, treatment outcomes, and psychological experiences, enabling assessment of the relationship between physical manifestations and emotional health.

Results: Irregular menstrual cycles were reported by 84% of participants and were frequently accompanied by fertility-related concerns. Excessive hair growth (77%) and hair thinning (69%) adversely affected participants’ confidence and body image. Obesity was observed in 63% of respondents and was frequently associated with reduced quality of life. Although 62% reported improvement with medication, 20% continued to experience psychological difficulties, particularly heightened anxiety, persistent low mood, and reduced self-worth. These findings indicate that PCOS significantly affects both physical functioning and psychological well-being.

Conclusion: PCOS exerts a substantial impact on women’s daily lives by affecting both physical health and emotional well-being. The persistence of psychological distress despite treatment underscores the need for integrated management approaches that combine lifestyle interventions, pharmacological therapy, and structured mental health support. Further research is required to identify high-risk subgroups and develop personalized strategies that support long-term wellness.

Effects of Anodal Prefrontal tDCS on Behavioral Symptoms and Cognitive Flexibility in Children with Learning Disabilities: A Quasi-Experimental Study

2026-02-01T07:47:04+00:00

Background & Objective: This study examined the effectiveness of transcranial Direct Current Stimulation (tDCS) applied to the prefrontal cortex in enhancing behavioral symptoms and cognitive flexibility among children with learning disabilities (LD).

Materials & Methods: A quasi-experimental pre-test–post-test design was adopted. The statistical population comprised all students with learning disabilities in Tabriz during the 1402–1403 academic year. Using purposive sampling, 30 students were selected and randomly allocated to experimental and control groups. Data were collected using the Stroop Test, the Achenbach Behavioral Problems Test (parent version), and a tDCS stimulation device. For the intervention, a 1.5 mA direct current was delivered across ten 20-minute sessions, with a 5 × 5 cm² anodal electrode positioned at F3 and a 5 × 7 cm² cathodal electrode placed at Fp2, both administering the same 1.5 mA current. Data were analyzed using multivariate analysis of covariance (MANCOVA) in SPSS.

Results: Significant improvements were found in internalizing behavioral problems (F = 91.39, p < 0.001, η² = 0.76), externalizing behavioral problems (F = 29.75, p < 0.001, η² = 0.51), and cognitive flexibility (F = 39.80, p < 0.001, η² = 0.58). These findings extend the application of tDCS to behavioral outcomes in children with learning disabilities, a population less frequently examined with respect to prefrontal stimulation compared to children with dyslexia, for whom reading-focused interventions are more common.

Conclusion: This non-invasive intervention appears promising as an adjunct to cognitive- behavioral therapies aimed at improving behavioral and cognitive symptoms in children with learning disabilities. The moderate-to-large effect sizes underscore its potential clinical significance. However, the absence of a sham control group, the small sample size (n = 30), and the lack of long-term follow-up assessments require caution when interpreting the causal implications and generalizing the findings.

Comparative Diagnostic Accuracy of the NEXUS Criteria and the Canadian C-Spine Rule in Cervical Spine Trauma

2026-02-01T07:47:03+00:00

Background & Objectives: Road traffic injuries are the fourth most common cause of death globally, according to surveys. The Canadian Cervical-Spine Rule (CCR) and the National Emergency X-Radiography Utilization Study (NEXUS) Low-Risk Criteria (NLC) are decision rules to guide the use of cervical-spine radiography in patients with trauma. In this study we aim to evaluate and compare the sensitivity and specificity of these rules in trauma patients for suspected C-spine injury.

Materials & Methods: 500 patients were prospectively enrolled, in the event of them meeting the criteria. They were subjected to radiologic studies (X-ray or CT) of the cervical spine if they met NEXUS criteria or the CCR.

Results: Of the 500 patients, 44.5% were subjected to radiography based on the NEXUS score and 58.8% based on the Canadian CCR. When the CCR was applied, the test was found to be 95.2% sensitive, 54.2% specific, 65% accurate, and with 42.6% positive predictive value and 97% negative predictive value. When NEXUS criteria were applied, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 100%, 75.3%, 59%, 100%, and 81.8%, respectively.

Conclusion: When the NEXUS score was applied, the diagnostic accuracy was better. With the CCR, a greater number of patients were subjected to radiological evaluation. Either of the two criteria may be applied for emergency care in the Indian population to avoid unnecessary investigations. CCR followed by NEXUS criteria is recommended, and the utilization of the same is to be studied in a larger population.

Synergistic Effects of an 8-Week Resistance Training Program and Creatine Supplementation on Hormonal, Metabolic, Inflammatory, and Body Composition Markers in 30- to 45-Year-Old Male Athletes: Modulation by ACTN3 (R577X)

2026-02-01T07:47:02+00:00

Background & Objectives: Optimizing metabolic health and physical performance in middle-aged male athletes is critical for long-term health maintenance and athletic sustainability. This study investigated the combined effects of an 8-week strength training (ST) program and creatine supplementation on anabolic hormones, metabolic indicators, inflammatory markers, and lean body mass (LBM) in 30- to 45-year-old male athletes, with particular emphasis on the potential moderating role of the ACTN3 genotype (R577X).

Materials & Methods: A randomized, placebo-controlled, 2 × 2 factorial design was employed, involving 48 recreationally trained male athletes who were randomly assigned to one of four groups: ST plus creatine (ST+C), ST plus placebo (ST+P), creatine supplementation alone, and a non-intervention control group (CON). The 8-week intervention consisted of supervised resistance training sessions and daily supplementation with either creatine or placebo. Venous blood samples were collected before and after the intervention to assess serum testosterone, growth hormone, cortisol, fasting glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), lipid profile parameters, and inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL- 6). ACTN3 genotyping was performed using standard molecular techniques. Data were analyzed using paired t-tests and analysis of covariance (ANCOVA), with inclusion of an exercise × creatine interaction term.

Results: The combined ST+C intervention resulted in a significant increase in LBM (p < 0.01, Cohen’s d = 0.85) and a significant improvement in insulin sensitivity, as evidenced by reduced HOMA-IR values (p < 0.05, Cohen’s d = 0.62), compared with all other groups. Creatine supplementation alone demonstrated a non-significant trend toward increased testosterone concentrations (p = 0.07). Participants in the ST+P group exhibited significant improvements in LBM and insulin sensitivity; however, these changes were less pronounced than those observed in the ST+C group. No significant between-group differences were observed for cortisol levels or inflammatory markers. ACTN3 genotype did not significantly moderate any of the measured outcomes.

Conclusion: Concurrent strength training and creatine supplementation effectively enhance LBM and insulin sensitivity in middle-aged male athletes. Creatine supplementation appears to confer additional benefits beyond resistance training alone, particularly with respect to anabolic hormonal responses. These findings support the use of combined resistance training and creatine supplementation as an effective strategy for optimizing metabolic health and physical performance in this population.

Effects of High-Intensity Interval Training and Moderate-Intensity Continuous Training on PGC-1α, SIRT3, and Non-Alcoholic Fatty Liver Disease: A Narrative Review

2026-02-01T07:47:00+00:00

Background & Objectives: This narrative review examines the effects of high-intensityinterval training (HIIT) and moderate-intensity continuous training (MICT) on keymitochondrial biomarkers, namely peroxisome proliferator-activated receptor gammacoactivator 1-alpha (PGC-1α) and sirtuin 3 (SIRT3), and evaluates their therapeutic rolesin metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known asnon-alcoholic fatty liver disease (NAFLD).

Materials & Methods: A systematic literature search was conducted in the Scopus,PubMed, ScienceDirect, and Elsevier databases using the keywords “HIIT,” “MICT,”“PGC-1α,” “SIRT3,” and “MASLD,” with no temporal restrictions applied. Studiespublished up to October 2025 were included. The initial search yielded approximately 600articles; following duplicate removal and title and abstract screening, 83 relevant studieswere selected for inclusion. Priority was given to recent evidence published between 2022and 2025 that incorporated the updated MASLD nomenclature.

Results: Both HIIT and MICT significantly upregulate PGC-1α and SIRT3 expression,thereby enhancing mitochondrial biogenesis, reducing oxidative stress, and improvinghepatic lipid metabolism. These molecular adaptations are associated with clinicallymeaningful outcomes, including reduced hepatic fat accumulation, improved insulinsensitivity, and enhanced liver function. HIIT tends to elicit more rapid molecular andmetabolic adaptations, whereas MICT is more consistently associated with sustainedlong-term benefits.

Conclusion: HIIT and MICT represent effective, evidence-based exercise interventionsfor the management of MASLD through modulation of mitochondrial signaling pathways.HIIT may be preferable when time efficiency is a priority, whereas MICT may be moresuitable for long-term adherence. An individualized exercise prescription, beginning withMICT and progressively incorporating HIIT, is recommended. The primary limitationsof this review include its narrative design and the potential for publication bias; therefore,future large-scale randomized controlled trials across diverse populations are warranted.

Genetics and Neuroscience Biomarkers in Attention-deficit/hyperactivity disorder: Insights toward Precision Medicine, A Systematic Review

2026-02-01T07:46:59+00:00

Background & Objectives: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 5 to 7% of children and 2 to 5% of adults worldwide, with heritability estimates of 70 to 80% reported in recent genome-wide association studies (GWAS) (1). The disorder arises from complex interactions among genetic, neurobiological, and environmental factors. This systematic review synthesizes recent advances in genetic and neuroscience-based biomarkers and evaluates their potential utility for precision medicine approaches in ADHD.

Materials & Methods: Study quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool and the Newcastle–Ottawa Scale. A systematic review of the literature published up to October 2025 was conducted, encompassing GWAS, neuroimaging studies (functional magnetic resonance imaging and electroencephalography), and clinical trials. The analysis focused on key genetic variants involved in dopamine regulation, including dopamine receptor D4 (DRD4), dopamine transporter 1 (DAT1), and catechol-O-methyltransferase (COMT), neurophysiological markers such as the theta-to-beta ratio, and polygenic risk scores (PRS) for treatment response prediction. Data were retrieved from PubMed and Scopus databases.

Results: Genetic variants affecting dopaminergic signaling were associated with increased ADHD susceptibility and differential responses to stimulant medications. The incorporation of PRS improved the prediction of treatment response by increasing explained variance, for example, R² values rose from 0.05 to 0.28, representing an absolute increase of approximately 23%, although relative improvements varied between 15 and 25% across studies. Electroencephalography-based neurofeedback demonstrated small-to-moderate improvements in executive functioning among inattentive ADHD subtypes, with standardized mean differences ranging from 0.36 to 0.44, although ongoing debates suggest that a substantial proportion of observed effects may reflect placebo-related mechanisms (I² = 50 to 65%). Neuroimaging findings consistently revealed hypoactivation of the prefrontal cortex and dysconnectivity within the default mode network, facilitating subtype differentiation. Integrative approaches employing artificial intelligence showed promise for individualized treatment planning; however, financial constraints, limited accessibility, and methodological heterogeneity currently hinder widespread clinical implementation.

Conclusion: Genetic and neurobiological biomarkers provide a robust foundation for precision- oriented ADHD care, encompassing neurofeedback and pharmacogenomic strategies. Standardization of biomarker assessment tools and the strategic integration of artificial intelligence are essential to overcoming existing barriers and promoting equitable, outcome-optimized interventions.