Category: Nevin Manimala

J Eat Disord. 2026 Apr 5. doi: 10.1186/s40337-026-01598-7. Online ahead of print.

ABSTRACT

BACKGROUND: Anorexia nervosa (AN) is a severe psychiatric disorder with high chronicity, particularly affecting adolescents. Existing treatments for adolescents do not always lead to full recovery. Recently, the developmentally adapted Maudsley Model of Anorexia Nervosa Treatment for Adolescents (MANTRa) has emerged as a promising alternative, warranting investigation into its outcome predictors.

METHODS: This secondary analysis is based on data from a multi-center cohort study conducted in several Austrian clinical settings. The study included 92 participants aged 13-21 years diagnosed with AN who received MANTRa (n = 45) or treatment-as-usual (TAU, n = 47). Statistical analyses focused on identifying baseline predictors and moderators of treatment success (change in eating disorder symptomatology) for the MANTRa and TAU groups at end-of-treatment and 18-month-follow-up. In addition to univariate linear regression models associating various predictor variables (BMI, eating disorder severity, depressive symptoms, weight suppression, illness duration, age of onset, motivation for change, and personality traits) with the long-term eating disorder outcome, we used a cluster analysis approach to categorize patients into high vs. low illness severity and “favorable” vs. “unfavorable” treatment motivation/personality profiles. Differences between clusters regarding treatment outcome were explored further.

RESULTS: In the MANTRa group, none of the examined baseline variables significantly predicted outcomes at 18-month follow-up in univariate models. In contrast, in the TAU group, higher initial eating-disorder psychopathology and lower motivation were associated with poorer outcomes. In MANTRa, there was a trend suggesting that patients with both high and low baseline illness severity, as well as those with unfavorable and favorable motivation/personality profiles, demonstrated sustained symptom reduction. By contrast, in the TAU group, sustained improvements were observed primarily among patients with low baseline illness severity and a favorable motivation/personality profile, whereas those with high illness severity and an unfavorable profile tended to show less benefit.

CONCLUSIONS: These results provide preliminary evidence for MANTRa as an effective, individualized treatment for adolescents with AN, including those exhibiting severe pathology, low baseline motivation and personality traits, e.g. low self-directedness, high harm avoidance and low cooperativeness. Future randomized controlled trials comparing MANTRa with established treatments are warranted to validate these findings and refine patient selection criteria.

TRIAL REGISTRATION: The original trial was registered at clinicaltrials.gov (Identifier NCT03535714).

PMID:41937155 | DOI:10.1186/s40337-026-01598-7

BMC Med. 2026 Apr 6. doi: 10.1186/s12916-026-04829-5. Online ahead of print.

ABSTRACT

BACKGROUND: Sarcopenia, the age-related loss of skeletal muscle mass and function, has been linked to adverse health outcomes. Cross-sectional associations have been observed between skeletal and cardiac muscle mass and function in healthy, community-dwelling older adults during normative aging. Further longitudinal studies on the skeletal muscle-cardiac axis during aging are needed to inform the temporal patterns and impact of these associations.

METHODS: We analyzed data from participants from the Baltimore Longitudinal Study of Aging. Individual longitudinal rates of change (random slopes) of echocardiography-derived cardiac function, appendicular lean mass (ALM), and maximal handgrip strength (HGS) were estimated with linear mixed-effects models. The associations between baseline measurements and rates of change (_Change) were examined using Pearson correlation and multiple linear regression. Continuous variables are expressed as mean ± standard deviation (SD).

RESULTS: Among 1025 participants (66.6 ± 13.1 years, 47.8% male), the baseline mean HGS was 33.1 ± 11.0 kg, and ALM was 20.8 ± 5.3 kg; the mean left ventricular ejection fraction was 67.5 ± 9.7%, and LV mass (LVM) was 145.6 ± 50.4 g. With aging, HGS decreased by 0.36 kg/year (95% CI: -0.41, -0.31), ALM decreased by 25.1 g/year (95% CI: -34.7, -15.5), and LVM decreased by 0.730 g/year (95% CI: -0.998, -0.460). Both ALM_Change and HGS_Change were inversely correlated with advancing age ([r = -0.159 p < 0.001] and [r = -0.172 p < 0.001], respectively), while LVM_Change was not (p = 0.178). Adjusting for baseline, ALM_Change was significantly associated with LVM_Change independently of age, sex, and LVM (β = 0.287, p < 0.001, adj. R² = 0.663); the association persisted after adjustment for pulse pressure, mean arterial pressure, and body mass index. The interaction term sex*baseline-adjusted ALM_Change was statistically significant (p < 0.050). ALM_Change was also correlated with LVEF_Change (r = 0.102, p = 0.001), while HGS_Change was not significantly correlated with LVM_Change (p = 0.642).

CONCLUSIONS: Among community-dwelling normative aging adults, age-associated decline in skeletal muscle mass correlated with reductions in LVM and function, independently of age, sex, and hemodynamic loading conditions. Our findings suggest a skeletal muscle-cardiac axis characterized by parallel declines beginning in early aging, preceding cardiovascular disease. Further studies exploring cardiac and skeletal muscle aging-related declines may direct interventions to halt these adverse processes concurrently.

PMID:41937125 | DOI:10.1186/s12916-026-04829-5

Biomed Chromatogr. 2026 May;40(5):e70441. doi: 10.1002/bmc.70441.

ABSTRACT

American ginseng (Panax quinquefolium L.) is a traditional Chinese medicinal herb that has been used in China for hundreds of years. The significant hypoglycemic activity of American ginseng has made it widely used in health food as a valuable medicinal herb with homologous origin. However, its effect and mechanism of improving insulin resistance (IR) remain unclear. In the present study, an IR-HepG2 cells model induced by high concentrations of insulin was constructed and treated with ethanol extract of dried American ginseng (EDAG) at different concentrations to reveal the in vitro ameliorative effect of EDAG on IR by monitoring glucose consumption, glycogen content, triglyceride (TG) content, and total cholesterol (TC) content of the cells. The cell metabolite changes were tracked by liquid chromatography-mass spectrometry (LC-MS)-based metabolomics combined with multivariate statistical analysis, the metabolic biomarkers and related metabolic pathways were analyzed, and further elucidate its mechanism of action. The results showed that treatment with EDAG increased glucose consumption and glycogen content, and decreased intracellular TC and TG content in IR-HepG2 cells to different degrees. The results of cell metabolomics indicated that EDAG treatment reversed metabolic disorders by regulating sphingolipid metabolism, linoleic acid metabolism, and arginine and proline metabolism, etc. The present study explored the in vitro IR improvement mechanism of EDAG based on the LC-MS cell metabolomics approach, which confirms the great potential of LC-MS technology in the evaluation of drug efficacy and can be an effective tool for the related analysis of other Chinese herbal medicines.

PMID:41937114 | DOI:10.1002/bmc.70441

J Dairy Sci. 2026 Apr 3:S0022-0302(26)00309-7. doi: 10.3168/jds.2025-27865. Online ahead of print.

ABSTRACT

The study aimed to determine whether ADG of Holstein heifers at various stages of rearing affects 1st and 2nd lactation performance. Data on BW of heifers were obtained from 3 independent dairy operators (operator A, B and C) and used to calculate ADG from birth until weaning (all operators), from weaning until 180 d of age (all operators), from 180 until 360 d of age (operator A and C), and from 360 until 410 d of age (operator A). Data sets included: 1583 records for the 1st and 1290 records for the 2nd lactation for operator A; 886 records for the 1st and 664 records the 2nd lactation for operator B; and 1190 records for the 1st and 675 records for the 2nd lactation for operator C. Subsequently, BW records were used to calculate ADG for each phase of rearing and used in a 2-step data analysis. In the first step, ADG was regressed against the 1st and 2nd 305-d lactation milk yield, 1st and 2nd 305-d lactation protein yield and 1st and 2nd 305-d lactation fat yield to test for a linear and quadratic relationship between those variables. In the second step, a statistical model was built which evaluated linear and quadratic impact of ADG, year and season of birth, year and season of calving, calving age, and dam parity (primi- or multiparous) on 1st and 2nd 305-d lactation milk, protein and fat yield. In both steps of analysis, pedigree data were used to correct phenotypic values for genetic effect. With increasing ADG preweaning (step 1), the 305-d milk yield in 1st lactation increased linearly for operator A and C but not for operator B, whereas 305-d milk yield in the 2nd lactation increased quadratically for operator A, linearly for operator C but no association was found for operator B. With increasing ADG from weaning until 180 d of age, the 305-d milk yield in 1st lactation increased linearly for all 3 operators, but the 305-d milk yield in 2nd lactation increased linearly for operator B and C, but not for operator A. With increasing ADG from 180 until 360 d of age, the 305-d milk yield in the 1st lactation decreased linearly for operator A but no association was found for operator C. With increasing ADG from 360 until 410 d of age (operator A), the 305-d milk yield in the 1st lactation decreased linearly. When other effects were included in the statistical model (step 2), the association of ADG with 305-d milk yield in the 1st and 2nd lactation found in step 1 of analysis oftentimes changed. This include direction or shape of the relationship, or its significance. Although some associations remained statistically significant, large variability around estimates suggests a substantial influence of unaccounted effects. Moreover, while with increasing ADG the 305-d milk yield increased, milk component yield in some instances decreased, or no association could be found. In summary, the relationship between ADG of heifers at different stages of growth and future milk and milk component yield differed substantially between operators, being either linear (both positive and negative), curvilinear or not significant, which makes clear conclusions difficult.

PMID:41937081 | DOI:10.3168/jds.2025-27865

J Dairy Sci. 2026 Apr 3:S0022-0302(26)00315-2. doi: 10.3168/jds.2025-28004. Online ahead of print.

ABSTRACT

Yogurt is a commonly consumed nutritious and healthy food and is an excellent carrier of prebiotics and probiotics. However, the survival of probiotics in the gut with the presence of gastric and intestinal juices and bile fluid is the main challenge. Hence, the yogurt formulation must be modified to resist the unhospitable environment of the gut and assist the probiotics in their survival. One strategy to overcome this limitation is the incorporation of prebiotics into probiotics containing yogurt. Prebiotics are mostly non-digestible food ingredients that assist in the survival, proliferation, and activity of beneficial microorganisms in the gut. Supplementation of yogurt with hemp seed protein concentrate (HP) and carrot powder (CP) as prebiotics may give sufficient protection to probiotics to survive in the human gut. We investigated the viability of probiotics in goat milk yogurt that was supplemented with plant-based prebiotics during 28-d storage at 4°C and in vitro simulated gastrointestinal transit. The basic mix for the yogurts had 82.85% milk, 10.68% powdered goat milk, and 6.47% sugar. Additionally, the mix was supplemented with CP (0.6%, T1), HP (2.5%, T2), and a combination of 0.6% CP and 2.5% HP (T3). A control (T0) yogurt without plant-based ingredients was also prepared. The mix was heated to 80°C for 30 min, cooled, and then inoculated with 2% of activated starter culture (YF-L812) and 2 probiotics (3% Bifidobacterium animalis BB-12 and 3% Lactobacillus acidophilus LA-5; Chr Hansen). Then the mixes were incubated at 43°C until the pH reached 4.4 to 4.6. The effects of plant-based prebiotics and probiotics on physicochemical properties such as composition, pH, acidity, water-holding capacity (WHC), and microbial counts of yogurts were studied. The addition of prebiotics and probiotics did not have any negative impact on the composition, WHC, lipid oxidation, firmness, antioxidant activity, and total phenolic content of yogurts. The presence of HP in yogurts significantly increased the viability of L. acidophilus LA-5 (LA) during storage. The prebiotics in yogurts did not affect (P > 0.05) the viability of Bifidobacterium animalis BB-12 (BB-12) during storage. The HP containing treatments in the presence of 0.3% bile salts positively affected the viability of Bifidobacteria in vitro simulated transit time and their counts exceeded 6 log cfu/g, which is the minimum required number for health benefits. The counts of LA in the HP containing treatments with 0.3% bile salts was one log lower than the threshold minimum.

PMID:41937079 | DOI:10.3168/jds.2025-28004

Travel Med Infect Dis. 2026 Apr 3:102977. doi: 10.1016/j.tmaid.2026.102977. Online ahead of print.

ABSTRACT

BACKGROUND: Acute mountain sickness (AMS) prevention requires prioritizing multiple interrelated determinants in pre-travel counseling. Conventional syntheses often focus on statistical significance of single factors and rarely integrate evidence strength (E*), effect magnitude (M*), and controllability (C*) into actionable priorities.

METHODS: We mapped factors into an E-M-C space and computed a Priority Index (PI = E* × M* × C* × kweight), with down-weighting for sparsely studied factors (kweight = 0.5 for k<5; 0.33 for k<3). Pooled effects were synthesized using conservative random-effects inference with prespecified robustness checks (heterogeneity assessment and influence/leave-one-out analyses).

RESULTS: Across 81 variable-level syntheses, heterogeneity was common but the principal signals remained stable under conservative inference and influence checks. High-priority risk signals were dominated by the ascent process (ascent speed, ascent mode-especially direct air travel-and attained/sleeping altitude), while acetazolamide prophylaxis remained the leading protective option. We identified an action-ready set (i.e., directly modifiable levers suitable for routine counseling) for immediate implementation. A small set of factors with greater uncertainty were classified as confirm-before-adopt (i.e., plausible but currently insufficient to drive routine advice), warranting standardized exposure contexts and multi-centre prospective validation.

CONCLUSIONS: The E-M-C framework and PI provide a quantitative, reproducible basis for prioritizing AMS prevention actions in pre-travel counseling. Despite common heterogeneity, the principal signals support high-yield, actionable counseling priorities.. Managing the ascent process and considering acetazolamide when indicated remain the most immediate, controllable risk-reduction options; importantly, the framework adds a structured way to rank competing determinants and communicate uncertainty to guide future evidence-building and iterative updates.

PMID:41937024 | DOI:10.1016/j.tmaid.2026.102977

J Gastrointest Surg. 2026 Apr 3:102412. doi: 10.1016/j.gassur.2026.102412. Online ahead of print.

ABSTRACT

INTRODUCTION: Multivisceral resection (MVR) in pancreatic ductal adenocarcinoma (PDAC) involves en bloc resection of adjacent organs due to direct invasion. Despite its clinical significance, adjacent organ invasion is not included as a determinant in AJCC staging or NCCN resectability criteria. This study aimed to evaluate the safety and efficacy of MVR compared to standard resection.

METHODS: We analyzed 1,222 patients who underwent surgery for PDAC between 2009 and 2019 at a tertiary institution. Patients with stage IV disease, recurrent operations, incomplete data, or MVR performed for double primary malignancy were excluded. Propensity Score Matching (PSM) was conducted at a 1:2 ratio, matching for operation type and AJCC T/N stages. Short- and long-term outcomes were compared between two groups.

RESULTS: Before PSM, 42 MVR cases and 1,099 standard resections demonstrated similar postoperative hospital stay lengths (11.4 vs. 12.6 days, p=0.094), major complications (23.8% vs. 19.0%, p=0.566), and clinically relevant postoperative pancreatic fistula (11.9% vs. 6.6%, p=0.310). However, MVR showed poorer long-term outcomes including 2-year overall survival rate (2YSR) (33.3% vs. 49.9%, p=0.006), 2-year disease-free survival rate (2YDFSR) (11.3% vs. 25.9%, p=0.018), and 2-year local recurrence rate (2YLRR) (41.3% vs. 30.9%, p=0.319). After PSM, both groups maintained similar short-term outcomes and showed no statistical difference in 2YSR (p=0.143), 2YDFSR (p=0.279), and 2YLRR (p=0.362).

CONCLUSION: MVR demonstrates comparable short- and long-term outcomes to standard resection and should be considered for selected patients with suspected organ invasion. These findings reinforce current staging and resectability criteria and support surgical decision-making for PDAC.

PMID:41936997 | DOI:10.1016/j.gassur.2026.102412

J Affect Disord. 2026 Apr 3:121742. doi: 10.1016/j.jad.2026.121742. Online ahead of print.

ABSTRACT

Affective disorders affect approximately 12% of the global population and include major depressive disorder (MDD) and bipolar disorder (BD), which often present with clinically indistinguishable depressive episodes. This highlights the need to identify reliable biomarkers for diagnostic differentiation. In this study, serum platelet-derived growth factor BB (PDGF-BB) and plasma thrombospondin-1 (TSP-1) were quantified by ELISA in 63 patients with MDD, 43 patients with BD, and 61 healthy controls. Patients were assessed during an acute depressive episode (T1) and in a (partially) remitted state (T2). Depressive symptom severity was evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS) (at T1: MDD = 33.16 ± 8.1; BD = 28.16 ± 9.74). Group differences and longitudinal changes were analyzed using non-parametric statistics, with adjustment for age, body mass index, and medication. PDGF-BB levels differed significantly between diagnostic groups during acute depression. Longitudinal analyses revealed significant lower levels of PDGF-BB from T1 to T2 in BD patients, but not in MDD patients, indicating a state-dependent change associated with remission in BD. These effects remained significant after adjustment for potential confounders, including lithium treatment. In contrast, TSP-1 levels showed no group- or state-dependent differences. When replicated, PDGF-BB may serve as a diagnostic biomarker distinguishing MDD from BD during acute episodes and as a potential state marker reflecting remission in bipolar disorder, even after accounting for relevant clinical confounders.

PMID:41936983 | DOI:10.1016/j.jad.2026.121742

J Affect Disord. 2026 Apr 3:121739. doi: 10.1016/j.jad.2026.121739. Online ahead of print.

ABSTRACT

BACKGROUND: Researchers have studied transcranial direct current stimulation (tDCS) as a possible treatment for major depressive disorder (MDD), especially for people with treatment-resistant depression (TRD). This systematic review and meta-analysis evaluate the effectiveness and safety of tDCS for TRD by analyzing data from randomized clinical trials.

METHODS: To evaluate the impact of tDCS on TRD, we adhered to the 2020 PRISMA guidelines and registered our protocol with PROSPERO (CRD42024606468). A comprehensive search was performed using keywords related to tDCS and TRD across six databases, focusing on English-language studies published until June 10, 2024. RCTs were included based on specific PICO criteria, with a thorough risk of bias assessment using the Cochrane ROB-2 tool. Statistical analyses were conducted using Stata-17 software.

RESULTS: A total of 448 studies were initially identified, with six studies (200 participants) meeting inclusion criteria for assessing immediate post-treatment effects of tDCS on TRD. Meta-analysis showed active tDCS significantly reduced depressive symptoms compared to sham (SMD: -1.17 [-1.85, -0.49]; P < 0.001). Significant outcome predictors included session number, age, male percentage, and duration. A follow-up analysis of delayed effects (30-day post-treatment), using four studies (154 participants), found no significant difference between active and sham tDCS (SMD: -0.12 [-1.98, 1.74]; P = 0.90).

CONCLUSIONS: This review suggests tDCS may provide modest, short-term benefits in TRD, but findings were inconsistent, highly heterogeneous, and based on limited small trials. Standardized, large-scale studies with optimized protocols and longer follow-up are needed to confirm efficacy and safety.

PMID:41936982 | DOI:10.1016/j.jad.2026.121739

Am J Clin Nutr. 2026 Apr 3:101305. doi: 10.1016/j.ajcnut.2026.101305. Online ahead of print.

ABSTRACT

BACKGROUND: Prebiotic fiber supplementation increases calcium absorption but its long-term effects on bone mass are mixed in children and adolescents.

OBJECTIVES: To determine the effect of one-year soluble corn fiber (SCF) supplementation compared to Placebo (maltodextrin; Main comparison), with or without calcium (calcium gluconate; Secondary comparison) on bone mineral content (BMC) and density (BMD) in children and adolescents with low habitual calcium intake through a randomized clinical trial. We hypothesized that SCF supplementation will result in higher bone mass.

METHODS: Healthy children and adolescents (9-14 years old) with usual low calcium intake were recruited and randomized for 1 year to SCF (12 g/d) or Placebo (12 mg/d), with or without calcium (600 mg/d). Bone mass was measured using dual energy x-ray absorptiometry (DXA) at baseline, 6 months and 12 months. Results are shown as mean±SD. Statistical analyses included linear mixed-effects and analysis of variance.

RESULTS: 213 participants were recruited and 177 were randomized. Most were White (41.3%), Hispanic (69.5%) and with healthy weight (74.0%). Girls had significantly higher Tanner score (3.10±1.20) compared to boys (2.30±1.20; p<0.001) and a significantly higher body fat % (p<0.05), therefore, results were stratified by sex. Among completers (n=151), whole-body BMC and BMD significantly increased from baseline to 6-months and to 12-months. In girls, 1-year gain in whole-body BMC was higher with SCF (216.3±138.3 g or 18.8%) compared to Placebo (139.9±84.0 g, 12.9%) after adjusting for age, Tanner stage, height velocity, weight velocity, lean mass velocity, fat mass velocity, and compliance (p<0.05). Similar results were found for BMD in girls. This was not observed in boys or when calcium supplementation was added.

CONCLUSIONS: 1-year supplementation with SCF resulted in a higher whole-body BMC and BMD compared to Placebo in girls only. This effect could have potential long-term benefits on bone mass acquisition in girls.

CLINICALTRIALS: GOV: NCT02916862; https://clinicaltrials.gov/study/NCT02916862 CLINICALTRIALS.

GOV REGISTRATION: NCT02916862.

PMID:41936980 | DOI:10.1016/j.ajcnut.2026.101305