Category: Nevin Manimala

J Hum Nutr Diet. 2026 Apr;39(2):e70244. doi: 10.1111/jhn.70244.

ABSTRACT

INTRODUCTION: Food insecurity, when individuals do not have sufficient access to food, has rapidly increased in high-income countries (HICs) since the 2008 global financial crisis. Women are particularly at risk of experiencing food insecurity, and during pregnancy, this can have detrimental physical and emotional health implications.

OBJECTIVE: To synthesise qualitative research exploring pregnant women’s experiences of food insecurity in HICs (PROSPERO 2023 CRD42023404774).

METHODS: Systematic review of qualitative literature reporting data on women’s experiences of food insecurity. Six databases (MEDLINE, Embase, Web of Science, CINAHL, ASSIA, Scopus) and grey literature sources were searched, followed by forwards and backwards citation chaining for all included studies. Screening of titles, abstracts and full-texts, data extractions and quality appraisals (using the Critical Appraisal Skills Programme (CASP) Qualitative Studies Checklist) were completed in duplicate. Certainty in the evidence was evaluated using GRADE-CERQual.

PARTICIPANTS/SETTING: Food-insecure pregnant and postnatal women, in HICs, since the global financial crisis of 2008.

MAIN OUTCOME MEASURES: Experiences of food insecurity during pregnancy.

ANALYSES: Thematic synthesis using NVivo14 to code data. Hand-drawn thematic maps were used to group codes into sub-themes and overarching themes. Coding and hand-drawn thematic maps were combined to create a final visual summary of analytical themes.

RESULTS: Searches resulted in 32,685 studies, and 32 were included (n = 20 North America, n = 10 Europe, n = 2 Australia). Findings identified three overarching themes: (1) barriers in access to food, (2) impact on physical and mental health, and (3) established individual, informal and statutory coping strategies. Women frequently discussed barriers to accessing fresh fruit and vegetables, resulting in poorer quality diets. Whilst qualitative data extracted precluded any direct pregnancy versus pre-pregnancy comparison, pregnancy appeared to exacerbate the experiences of food insecurity for women. The future arrival of a newborn created additional financial concerns along with worries over nutritional needs. Reliance on others was a recurrent strategy for pregnant women to mitigate the impact of food insecurity. The GRADE CERQual assessment showed moderate to high confidence in all findings.

CONCLUSIONS: The findings of this qualitative review-the first to focus on experiences of food insecurity during pregnancy across HICs-show that women are experiencing substantial impacts from food insecurity during this critical life course stage. Review findings emphasise the need for co-ordinated screening and interventions that aim to support women to mitigate the impacts of food insecurity and its underlying causes to improve postpartum health and wellbeing.

PMID:41975237 | DOI:10.1111/jhn.70244

Commun Med (Lond). 2026 Apr 13. doi: 10.1038/s43856-026-01541-6. Online ahead of print.

ABSTRACT

BACKGROUND: Long COVID is a complex condition where symptoms persist for more than 3 months after SARS-CoV-2 infection and affects an estimated 5-30% of individuals. While persistent inflammation has emerged as an important feature of this condition, it is unclear if immune responses from COVID-19 vaccination or SARS-CoV-2 re-infection exacerbate or mirror the initial inflammatory responses.

METHODS: We quantified 182 inflammatory and neurology-related proteins in plasma using multiplexed affinity proteomics. Plasma samples from the COVID PROFILE cohort conducted in Victoria, Australia, were collected 6-9 months after first infection, but before COVID-19 vaccination from individuals who had recovered from COVID-19 (n = 21) or from individuals with long COVID (n = 12). To establish baseline plasma profiles, protein levels were benchmarked against unvaccinated, SARS-CoV-2 naive individuals (n = 24). In addition, we performed longitudinal analysis in a subset of individuals (n = 34), where paired samples collected 2-4 weeks after a third COVID-19 vaccine dose and after SARS-CoV-2 breakthrough infection were available to assess inflammatory and neurology protein plasma levels after antigen exposure in these contexts.

RESULTS: In this cohort Boruta feature selection and lasso regression models identified IL-20, HAGH, NAAA, CLEC10A, LXN, and MCP-1, TRAIL, G-CSF, NBL1, and CCL23 as best discriminating proteins when comparing the long COVID group to groups of either healthy or COVID-19 recovered. Notably, longitudinal analysis indicated differences in the levels of a subset of plasma proteins following primary infection compared to after COVID-19 booster vaccination and breakthrough infection within the groups.

CONCLUSIONS: These findings suggest that there is an altered immune response outcome primarily observed in individuals with long COVID upon re-exposure.

PMID:41975235 | DOI:10.1038/s43856-026-01541-6

Nurs Crit Care. 2026 May;31(3):e70497. doi: 10.1111/nicc.70497.

ABSTRACT

BACKGROUND: Evidence-based practice (EBP) refers to the combination of clinical expertise, the best available research and individual patient preferences. It is a fundamental aspect of contemporary nursing, designed to enhance patient outcomes through thoughtful and informed clinical decision-making. The specific correlation between nursing informatics competency, demographic characteristics and EBP competency, particularly in intensive care units (ICUs), remains largely unexplored in Palestine.

AIM: This study aimed to assess the relationship between nursing informatics competency and EBP competency among ICU nurses in the West Bank.

STUDY DESIGN: A cross-sectional, descriptive correlational design with a convenience sampling method was employed to recruit 250 nurses in intensive care units in 18 governmental hospitals across the West Bank during the period from April 10 to June 15. Data were collected using a self-reported survey consisting of the Self-Assessment of Nursing Informatics Competencies Scale (SANICS), the Evidence-Based Practice Competency Questionnaire and socio-demographic variables. Data were analysed using descriptive statistics, Pearson and point-biserial correlations and multiple linear regression.

RESULTS: A total of 227 participants responded and reported levels of moderate nursing informatics competency (M = 3.1, SD = 0.2) and moderately high evidence-based practice competency (M = 79.0, SD = 12.8). A strong positive correlation was found between EBP competency and nursing informatics competency (r = 0.890, p < 0.001) and the number of hours spent using EMRs/shift (r = 0.748, p < 0.001). A positive correlation existed between EBP competency and the number of research articles read monthly (r = 0.356, p < 0.001). Age (r = -0.456, p < 0.001) and years of nursing experience (r = -0.447, p < 0.001) were negatively correlated with EBP competency. Additionally, previous EBP training (p.b.r = 0.482, p < 0.001) and holding higher education (p.b.r = 0.410, p < 0.001) were associated with EBP competency. Nursing informatics competency, number of articles read monthly, number of hours spent on EMR/shift, educational level and previous training in EBP were significant predictors of EBP.

CONCLUSION: These results highlight the essential contribution of nursing informatics competency, ongoing professional growth and regular engagement with research to the development of EBP competency.

RELEVANCE TO CLINICAL PRACTICE: To further strengthen EBP capabilities among nurses, it is important to design initiatives that enhance informatics training, expand access to research materials and cultivate educational environments that promote evidence-based care.

PMID:41975211 | DOI:10.1111/nicc.70497

J Perinatol. 2026 Apr 13. doi: 10.1038/s41372-026-02615-y. Online ahead of print.

ABSTRACT

ABSTARCTS: OBJECTIVE: To evaluate the association between orotracheal versus nasotracheal intubation route and unplanned extubation (UE) risk among infants.

STUDY DESIGN: This retrospective cohort study included all tracheal intubation (TI) events among infants admitted to a level IV NICU from 2022 to 2024. Kaplan-Meier survival analysis was used to assess UE risk by TI route.

RESULT: There were 1160 TI events and 23 UEs during the study period. The UE rate was three times lower in the nasotracheal intubation group compared to orotracheal (0.01 vs. 0.03 per 100 ventilator days). UE risk was significantly higher in orotracheally intubated infants (p = 0.03) with no differences when stratified by sex, gestational age, or birth weight.

CONCLUSION: Nasotracheal intubation was associated with lower UE risk in infants in a unit that predominantly performs nasotracheal intubation. Prospective randomized studies are needed to further investigate if TI route may contribute to fewer UEs in this population.

PMID:41975210 | DOI:10.1038/s41372-026-02615-y

J Perinatol. 2026 Apr 13. doi: 10.1038/s41372-026-02653-6. Online ahead of print.

ABSTRACT

OBJECTIVE: Determine prenatal and neonatal factors that predict infantile outcomes in patients with congenital heart disease (CHD).

STUDY DESIGN: Retrospective cohort of 415 neonates with CHD admitted to a neonatal intensive care unit (NICU). Statistical tests included Chi-square, Fisher’s Exact, Kruskal-Wallis, and multivariable logistic regression.

RESULTS: Cardiac lesion type was associated with mortality, length of stay, and enteral feeding tube support at discharge (EFTD) (p ≤ 0.01). A genetic diagnosis and an extra-cardiac congenital anomaly were associated with higher odds of respiratory support needs at discharge (RSND) [OR 2.8 (95% CI: 1.2, 6.5); 4.8 (1.9, 11.8)] and EFTD [5.5 (2.9, 10.8); 3.4 (2.4-9.7)]. Lower birth weight was associated with higher odds of RSND [0.5 (0.38, 0.66)], and lower gestational age with higher odds of EFTD [0.84 (0.75, 0.95)].

CONCLUSION: Several factors predicted adverse outcomes in infants with CHD, helping to identify high-risk cases for targeted care and improved parental guidance.

PMID:41975206 | DOI:10.1038/s41372-026-02653-6

J Autoimmun. 2026 Apr 12;160:103560. doi: 10.1016/j.jaut.2026.103560. Online ahead of print.

ABSTRACT

PURPOSE: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a serious manifestation of systemic lupus erythematosus (SLE), yet its neuroimaging diagnosis remains challenging. This study aims to explore the value of FW-corrected diffusion model parameters in characterizing white matter microstructural alterations in patients with NPSLE.

MATERIALS AND METHODS: This cross-sectional, case-control study enrolled patients with 33 inflammatory NPSLE patients, 24 ischemic NPSLE patients, and 33 SLE patients without neuropsychiatric manifestations (non-NPSLE) at the time of inclusion between September 2023 and March 2024. All participants underwent diffusion MRI. Tract-based spatial statistics (TBSS) were used to compare white matter differences among groups. Regions showing significant differences were used as regions of interest (ROI) to extract mean FW values. These imaging features were combined with clinical indicators (age, Montreal Cognitive Assessment (MoCA) scores, Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores) to construct multiple machine learning classification models. Model performance was evaluated using internal and external validation.

RESULTS: TBSS analysis revealed that only the FW parameter showed significant differences between inflammatory NPSLE and non-NPSLE patients, specifically manifested as significantly elevated FW values in the bilateral hippocampal cingulum bundles. In internal validation, Linear Discriminant Analysis (LDA), Adaptive Boosting (AdaBoost), and Logistic Regression (LR) classifiers demonstrated optimal performance (area under the curve (AUC) = 0.910, accuracy 85.0%). In external validation, LDA and LR classifiers achieved the highest AUC value (0.956) and accuracy (92.86%).

CONCLUSION: Elevated FW in the bilateral hippocampal cingulum bundles of inflammatory NPSLE patients likely indicates neuroinflammation. A diagnostic model combining FW parameters from this region with clinical indicators shows strong potential for distinguishing inflammatory from non-inflammatory NPSLE.

PMID:41974094 | DOI:10.1016/j.jaut.2026.103560

J Environ Manage. 2026 Apr 12;405:129654. doi: 10.1016/j.jenvman.2026.129654. Online ahead of print.

ABSTRACT

This study introduces the Ecosystem Carrying Capacity Assessment System (ECCAS), a unified web-based platform that integrates multi-source geospatial data, physical models, and statistical tools within a modular architecture to dynamically assess ecosystem carrying capacity, quantified as water-sustainable gross primary productivity (GPPs). The platform enables scenario-based simulations by coupling future climate projections with adjustable socio-economic parameters and provides interactive visualization to improve accessibility for non-expert users. Applied to China’s Loess Plateau, a water-limited region undergoing large-scale ecological restoration, ECCAS reveals that 24% of vegetated areas historically exceeded sustainable water thresholds, with pronounced overuse in mountainous regions. Future projections indicate consistent increases in GPPs across all scenarios, with the largest growth reaching up to 50% by the 2050s, highlighting both opportunities for carbon sequestration and emerging pressures on water resources. The modular design ensures transferability to other dryland regions, providing a flexible and interactive platform for supporting land and water management under changing environmental conditions.

PMID:41974081 | DOI:10.1016/j.jenvman.2026.129654

Am J Health Promot. 2026 Apr 13:8901171261442056. doi: 10.1177/08901171261442056. Online ahead of print.

ABSTRACT

PurposeTo assess U.S. parents’ perceptions of the healthfulness and safety of non-sugar sweeteners (NSS) and examine their views of NSS front-of-package labels (FOPLs).DesignCross-sectional online survey conducted in August 2024.SettingNational online survey distributed to U.S. parents through a research panel platform.ParticipantsA total of 1047 parents of children aged 2-12 years.MethodsThe questionnaire assessed perceptions of NSS compared with added sugars, confidence in identifying NSS, and evaluations of proposed FOPL formats. Descriptive statistics and were used to summarize all responses. Stratified analyses were conducted by demographic and health characteristics to examine differences in views across five hypothetical NSS FOPL formats.ResultsMost parents viewed NSS as helpful for reducing sugar intake for themselves (82%) and their child (58%), with 52% preferring NSS-containing products over those high in added sugars. While 79.8% and 61.4% considered occasional NSS use safe for adults and children, respectively, only 21.9% viewed daily use as safe for children. Natural NSS were perceived as safer than artificial (60.5% vs 26.6%). Nearly all parents (92.6%) indicated that an NSS FOPL would facilitate product identification, and 76.3% supported mandatory labeling, particularly a yellow triangle stating “Not recommended for children.” The preference for this FOPL was consistent among participants of different demographic and health characteristics.ConclusionParents acknowledged potential benefits of NSS for sugar reduction but expressed caution about children’s intake, showing strong support for mandatory, child-focused FOPL.

PMID:41974045 | DOI:10.1177/08901171261442056

Hepatol Commun. 2026 Apr 13;10(5):e0932. doi: 10.1097/HC9.0000000000000932. eCollection 2026 May 1.

ABSTRACT

Hepatocellular carcinoma (HCC) remains a major global cause of cancer morbidity and mortality, with marked geographic heterogeneity in incidence and outcomes. The highest age-standardized incidence and mortality rates persist in East Asia and across much of Africa. In contrast, Europe and North America exhibit moderate incidence, while Latin America and Oceania represent intermediate-burden regions with important subregional heterogeneity, with higher mortality concentrated in underserved, rural, Indigenous, and remote populations. Globally, the etiologic landscape of HCC is shifting from predominantly infection-related toward metabolic dysfunction and alcohol-associated liver disease. Rural-urban disparities further exacerbate global HCC burden through gaps in vaccination coverage, antiviral access, diagnostic infrastructure, and specialty care, leading to later-stage presentation and poorer outcomes. In this review, we describe the epidemiological changes in HCC across different areas of the world, focusing on region-specific issues and identifying key aspects of epidemiological transition.

PMID:41974030 | DOI:10.1097/HC9.0000000000000932

Ann Am Thorac Soc. 2026 Jan 30:aaoag006. doi: 10.1093/annalsats/aaoag006. Online ahead of print.

ABSTRACT

RATIONALE: Long-term exposure to air pollution contributes to chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). While the effect of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) are supported by evidence, the contribution of black carbon (BC), a combustion-related pollutant, remains unclear.

OBJECTIVES: To investigate associations of long-term exposure to BC as well as PM2.5 and NO2 with incidence of adult-onset asthma and COPD in Denmark.

METHODS: We followed 3.2 million Danish residents aged 30 years or older on January 1, 2000 until December 31, 2018, for incidence of asthma and COPD (first hospital contact), and combined incidence [first prescription for obstructive airway disease (OAD) medication]. Annual mean concentrations of air pollutants were estimated using European-wide hybrid land-use regression models. Cox proportional hazard models were used with adjustment of demographic, socioeconomic factors, smoking, and body mass index.

RESULTS: During 50.7, 50.4, and 44.4 million person-years of follow-up, 52,648 participants developed asthma, 146,269 developed COPD, and 393,211 were prescribed OAD medication, respectively. An interquartile range increase of 2.0 and 10.3 µg/m3, and 0.5 × 10-5/m in PM2.5, NO2, and BC, respectively, were associated with higher risks of asthma incidence [hazard ratio: 1.10 (95% confidence interval: 1.08, 1.13); 1.16 (1.13, 1.19); 1.17 (1.14, 1.20)], COPD incidence [1.04 (1.02, 1.05); 1.05 (1.03, 1.07); 1.06 (1.04, 1.08)], and OAD medication [1.02, (1.01, 1.03); 1.05 (1.03, 1.06); 1.03 (1.02, 1.05)]. The observed association with PM2.5 were attenuated or became null after adjusting for NO2 or BC, while those with NO2 or BC remained robust after adjusting for PM2.5.

CONCLUSION: In a large Danish nationwide analysis, air pollution is an important predictor for adult-onset asthma and COPD. Our findings suggest that the relevance of pollutants originating from combustion sources, as reflected by the association with BC and NO2, may contribute importantly to these respiratory outcomes. Targeted actions to reduce combustion-related emissions, including those leading to BC formation, may further help decrease the burden of chronic respiratory diseases.

PMID:41973987 | DOI:10.1093/annalsats/aaoag006