Nevin Manimala

Biol Lett. 2026 Apr 15;22(4):20250829. doi: 10.1098/rsbl.2025.0829.

ABSTRACT

Warm, dry environments create living conditions that challenge plant growth, reproduction and survival. Plants in these environments have evolved adaptive strategies to enhance water-use efficiency and ensure reproductive success, two of which are annuality and C4 photosynthesis. However, life history variation is rarely included in large-scale studies of plant diversity, and the extent to which these traits coevolve and are jointly selected for is not known. To address this, we used Pagel’s models of independent and correlated evolution for over 4000 species of grasses (Poaceae), while accounting for evolutionary rate heterogeneity and potential type I statistical errors. We found that there are more C4 than C3 annuals and that C4 origins predate evolution of annuality, but no support for correlated evolution between the two traits. Our results indicate that any habitat or trait similarities (e.g. small seeds, fast growth) between annuals and C4 species reflect independent adaptations to similar environmental conditions or are contingent on the two traits themselves, rather than the result of evolutionary or functional links between them. Our results further highlight the importance of appropriate null model specification for testing evolutionary hypotheses across large, old clades.

PMID:41983260 | DOI:10.1098/rsbl.2025.0829

Phytother Res. 2026 Apr 15. doi: 10.1002/ptr.70324. Online ahead of print.

ABSTRACT

Primary dysmenorrhea is defined as recurrent, cramp-like lower abdominal pain occurring during menstruation in the absence of underlying pelvic pathology. A significant proportion of the population opts for natural plant-based remedies due to their perceived lower incidence of adverse effects. This study aims to evaluate the efficacy of plant-based interventions in the management of primary dysmenorrhea. Systematic review and meta-analysis. A comprehensive search was conducted across five databases (PubMed, Web of Science, Medline, Embase, and Scopus) covering the period from 1990 to 2025. Randomized controlled trials (RCTs) investigating the efficacy of plant-based products or herbal medicine for the treatment of primary dysmenorrhea were included. Searches, data extraction, and risk of bias assessment were performed independently by two reviewers. Discrepancies were resolved through consultation with a third reviewer expert in the topic. A total of 47 studies were included in the systematic review, of which 22 were incorporated into the meta-analysis. The findings indicate that herbal medicine can be as effective as conventional pharmacological treatments (n = 1133, MD: 0.12, 95% CI: -0.29 to 0.53, p = 0.58, I² = 95%), such as mefenamic acid or ibuprofen, in managing primary dysmenorrhea. Additionally, a statistically significant difference was observed when compared to placebo (n = 941, MD: -1.83, 95% CI: -2.32 to -1.34, p < 0.00001, I² = 92%). Adverse effects were infrequent, mild in severity, and resolved upon discontinuation of the intervention. Overall, the certainty of evidence is low to very low due to high heterogeneity and moderate risk of bias. Plant-based treatments may reduce pain associated with primary dysmenorrhea and are probably comparable to conventional drug therapies. However, further studies employing more rigorous methodologies are required to establish stronger evidence regarding the efficacy and safety of herbal medicine in addressing this health condition.

PMID:41983255 | DOI:10.1002/ptr.70324

Front Psychiatry. 2026 Mar 30;17:1727227. doi: 10.3389/fpsyt.2026.1727227. eCollection 2026.

ABSTRACT

PURPOSE: To evaluate whether anti-glutamic acid decarboxylase (Anti-GAD) antibodies and selected biochemical parameters are associated with autism spectrum disorder (ASD), symptom severity, and autistic regression in a case-control design. We hypothesized that Anti-GAD titers would be higher in ASD and associated with greater symptom burden.

MATERIALS AND METHODS: Children aged 2-9 years with ASD diagnosed according to DSM-5 criteria and age- and sex-matched healthy controls were included. Laboratory analyses assessed Anti-GAD, ASO, ferritin, iron, vitamin D, vitamin B12, thyroid-stimulating hormone, and folate. Clinical evaluations included the Autism Behavior Checklist (ABC), Modified Checklist for Autism in Toddlers (M-CHAT), and Ankara Developmental Screening Inventory (AGTE). Autistic regression was defined as loss of previously acquired language and/or social communication skills lasting ≥3 months between 15 and 30 months of age.

RESULTS: Ninety children participated (45 with ASD and 45 controls). Anti-GAD antibody levels were higher in the ASD group than in controls (p = 0.003). Although statistically significant, the absolute difference between groups was modest. Among ASD cases, 62% met criteria for regression; this relatively high proportion may reflect the clinic-based sampling and the operational definition applied. Compared with those without regression, children with regression had higher Anti-GAD titers and ABC scores but lower iron and ferritin levels (all p < 0.05). Anti-GAD levels correlated positively with ABC total scores (r = 0.724, p = 0.01). These findings reflect statistical associations and do not imply causality.

CONCLUSION: Higher Anti-GAD antibody levels were statistically associated with ASD, autistic regression, and greater behavioral symptom severity in this sample. These results suggest possible immune-related contributions to ASD heterogeneity; however, larger longitudinal studies are needed before clinical or biomarker implications can be established.

PMID:41983249 | PMC:PMC13071506 | DOI:10.3389/fpsyt.2026.1727227

Front Psychiatry. 2026 Mar 30;17:1753003. doi: 10.3389/fpsyt.2026.1753003. eCollection 2026.

ABSTRACT

BACKGROUND: Sleep is essential for optimal health; however, the prevalence of poor sleep, characterized by disrupted patterns and qualities, adversely affects psychological well-being and cognitive function. This issue is prevalent, yet it is frequently underdiagnosed and inadequately managed. Current therapeutic options exhibit notable limitations. The Stellate Ganglion Block (SGB) may alleviate sleep disturbances through various physiological mechanisms; however, its safety and efficacy remain subjects of ongoing debate. This meta-analysis systematically evaluates the efficacy of SGB using objective metrics to provide high-quality clinical evidence and to inform future research directions.

METHODS: Literature searches were conducted in PubMed, Web of Science, Embase, the Cochrane Library, OVID, and Google Scholar from database inception to June 2025. Analyses were performed with RevMan 5.4 software, and the study was registered on PROSPERO (CRD420251040732) .

RESULTS: Seven studies met the inclusion criteria. In comparison to the control group, patients who received the SGB demonstrated a statistically significant increase in total sleep time (WMD: 60.86; 95% CI, 38.05 to 83.66; P < 0.001). Additionally, these patients exhibited lower scores on the Pittsburgh Sleep Quality Index (PSQI) (WMD: -1.22; 95% CI, -1.80 to -0.65; P < 0.001), reduced sleep onset latency (WMD: -1.59; 95% CI, -2.48 to -0.69; P < 0.001), and enhanced deep sleep quality, as indicated by lower scores on the deep sleep quality assessment (WMD: -1.42; 95% CI, -1.95 to -0.89; P < 0.001).

CONCLUSION: The SGB shows promise in alleviating sleep problems. However, a lack of high-quality studies, insufficient long-term follow-up, and incomplete participant demographic data limit the existing evidence. There is a pressing need for extended follow-up and multicenter randomized controlled trials (RCTs). Future research should explore the potential synergies between stellate ganglion block and cognitive behavioral therapy (CBT-I) for sleep disorder to assess the sustainability of its efficacy and to expand the population that may benefit from this intervention.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251040732.

PMID:41983247 | PMC:PMC13071040 | DOI:10.3389/fpsyt.2026.1753003

J Pharm Policy Pract. 2026 Apr 13;19(1):2650578. doi: 10.1080/20523211.2026.2650578. eCollection 2026.

ABSTRACT

BACKGROUND: The digitalisation of healthcare requires nurses to possess strong Digital Health Literacy (DHL) to ensure patient safety. This study aimed to evaluate the relationship between DHL and perceptions of PSC among registered nurses in Jordan and to identify the demographic and professional factors associated with varying levels of DHL.

METHODS: A multi-center, cross-sectional survey was conducted from July to September 2025 across five public, private, and university-affiliated hospitals in Jordan. A sample of 500 registered nurses was recruited using stratified random sampling. Data were collected using a validated, seven-part composite questionnaire. Data were analyzed using descriptive statistics, reliability analysis (Cronbach’s alpha), and structural equation modelling.

RESULTS: The results confirmed the study’s primary hypothesis, revealing a significant and strong positive predictive relationship between DHL and PSC (β = 0.42, p < 0.001), with DHL explaining 28.1% of the variance in PSC. Nurses reported moderately high DHL overall (M = 3.28), with strengths in operational skills but lower confidence in evaluating information reliability. Perceptions of patient safety culture were positive (M = 3.71), with Teamwork Climate rated highest (M = 4.21) and Perceptions of Management lowest (M = 3.34). Significant disparities in DHL were found; higher levels of education (p < .001) and working in a university-affiliated hospital (p = 0.001) were associated with higher competency. Notably, no significant differences were observed based on age or years of experience. Lack of adequate training and insufficient time were identified as the primary organisational barriers to technology use.

CONCLUSION: Digital health literacy was significantly associated with better patient safety culture among Jordanian nurses, driven more by organisational and educational factors than generational stereotypes. To realise the safety benefits of digital health investments, institutions should strengthen nurses’ digital and critical appraisal skills and remove organisational barriers.

PMID:41983241 | PMC:PMC13072690 | DOI:10.1080/20523211.2026.2650578

PeerJ. 2026 Apr 10;14:e21025. doi: 10.7717/peerj.21025. eCollection 2026.

ABSTRACT

BACKGROUND: High-Intensity Focused Ultrasound (HIFU) is an emerging non-invasive therapy for breast fibroadenoma. However, its efficacy across different breast glandular types, which may influence acoustic energy deposition, remains underexplored.

OBJECTIVE: This study sought to investigate the treatment efficacy of ultrasound (US)-guided HIFU for breast fibroadenoma with respect to different breast gland types.

METHODS: A retrospective analysis was conducted on 201 patients (314 lesions) with biopsy-confirmed breast fibroadenomas treated between January 2024 and November 2024. Patients were stratified into four groups based on the American College of Radiology (ACR) breast composition classification: fatty group (<25% glandular tissue), loose group (25-50%), mixed group (51-75%), and dense group (>75%). All patients underwent ultrasound-guided HIFU ablation using the JC-200 system (Chongqing Haifu Medical Technology Co., Ltd., China). The baseline characteristics of patients, lesion features of fibroadenomas, relevant parameters during HIFU treatment, follow-up duration, and tumor volume reduction rate (VRR) were recorded and comparatively analyzed. Statistical analyses included One-Way Analysis of Variance (ANOVA) with least significant difference (LSD)-t tests for pairwise comparisons.

RESULTS: The average surgical power in the loose group (142.8 ± 38.5 W) was significantly higher than that in the fatty group (128.7 ± 23.3 W), mixed group (128.8 ± 36.6 W), and dense group (121.4 ± 39.5 W), with statistically significant differences (P < 0.05). The post-HIFU treatment average VRRs for the fatty, loose, mixed, and dense groups were 72.9 ± 16%, 61.6 ± 24%, 55 ± 22%, and 49 ± 32%, respectively. LSD-t test analysis revealed statistically significant differences between pairwise comparisons, including fatty vs. loose, fatty vs. mixed, fatty vs. dense, and loose vs. dense groups (P < 0.05).

CONCLUSION: HIFU is a safe and effective treatment for fibroadenomas across different breast gland types. The significantly superior VRR in fatty-type breasts underscores the critical role of preoperative breast gland typing in predicting HIFU outcomes. These findings advocate for the integration of breast density assessment into clinical decision-making to optimize individualized HIFU treatment planning for benign breast tumors.

PMID:41983234 | PMC:PMC13075401 | DOI:10.7717/peerj.21025

PeerJ. 2026 Apr 10;14:e21091. doi: 10.7717/peerj.21091. eCollection 2026.

ABSTRACT

BACKGROUND: Unstable core training (UCT), widely used in various sports to enhance trunk muscle strength and sprint performance, results in significantly greater gains in both outcomes compared to traditional core training (TCT). The study aimed to examine the impact of UCT performed on unstable surfaces (Both Side Up (BOSU) balls, Swiss balls and Wobble boards) versus TCT performed on stable surfaces (floor and bench) on trunk muscle strength and sprint performance among flatwater sprint kayakers.

METHOD: A randomized controlled trial was conducted, recruiting 60 eligible kayakers aged 14-19 years from the Ganzhou training base, China. Participants were randomly assigned to the UTC group and the TCT group. Both groups completed an 8-week core training program consisting of 1-hour sessions, 3 times/week. The difference is that the core training exercises of the UTC group were performed on unstable surfaces, while the TCT group was performed on stable surfaces. Trunk stability strength was assessed using the abdomen, back, and side bridge tests, while trunk dynamic strength was measured using the 1-minute sit-up, 1-minute back extension, and 1-minute trunk rotation tests. Sprint performance was evaluated using the 200 m single flatwater sprint time test. Statistical analyses were conducted via Multivariate Analysis of Variance (MANOVA), with the significance level set at p < 0.05.

RESULTS: Both the UTC and TCT groups demonstrated significant improvements from pre- to post-intervention across all dependent variables. However, the analysis of between-group effects revealed statistically significant greater improvements in the UTC group compared with the TCT group at post-test. These differences included These differences included trunk stability strength in terms of abdomen (p < 0.001, η ² = 0.228), back (p < 0.001, η ² = 0.285), left side (p < 0.001, η ² = 0.280), and right side (p < 0.001, η ² = 0.291); trunk dynamic strength in terms of flexion (p < 0.001, η ² = 0.243), extension (p < 0.001, η ² = 0.212), left rotation (p < 0.001, η ² = 0.182), and right rotation (p < 0.001, η ² = 0.303); as well as sprint performance in terms of 200m single flatwater sprint time (p < 0.001, η ² = 0.739).

CONCLUSION: The findings suggest that UTC may lead to greater improvements in trunk muscle strength and sprint performance compared with TCT over an 8-week intervention among young male Chinese kayakers. However, given methodological limitations (field-based strength tests and manual timing), results should be interpreted cautiously and require confirmation with more precise measurement methods in future research.

PMID:41983232 | PMC:PMC13075397 | DOI:10.7717/peerj.21091

Health Psychol Behav Med. 2026 Apr 10;14(1):2656029. doi: 10.1080/21642850.2026.2656029. eCollection 2026.

ABSTRACT

BACKGROUND: Healthcare students face intense emotional and academic stress, leading to anxiety and poor mental health. Body-Mind Axial Awareness (BMAA)-a movement-based, body-centered practice-integrates bodily awareness and interoceptive attention to promote mind-body regulation and mental health.

METHODS: A pretest-posttest controlled design was used with 38 students in the BMAA group and 27 in the control group. Group differences arising from non-random enrollment were statistically adjusted using analysis of covariance (ANCOVA), and within-group changes were examined using paired t-tests and repeated-measures multivariate analysis of variance (MANOVA). Participants completed eight weeks of BMAA training involving weekly two-hour sessions and daily home practice. Assessments before and after intervention included four domains of psychological functioning, measured using validated instruments: body awareness (Body Awareness Ability Inventory; Multidimensional Assessment of Interoceptive Awareness), mindfulness (Mindful Attention Awareness Scale), positive embodiment (Experience of Embodiment Scale), and mental health (Adult Mental Health Scale; Toronto Alexithymia Scale-20; State-Trait Anxiety Inventory-Trait; Satisfaction with Life Scale).

RESULTS: After controlling for baseline differences, the BMAA group showed greater gains than the control group in body awareness, mindfulness, positive embodiment, and mental health. Within-group analyses further indicated that BMAA participants demonstrated significant pre-post improvements across most body awareness and mindfulness subscales (except Not-Distracting and Not-Worrying), as well as across embodiment dimensions (except Resisting Objectification), along with enhanced emotional awareness and expression, reduced anxiety, and higher life satisfaction (p < .05 for relevant comparisons). Despite the absence of random assignment and modest group-size imbalance, ANCOVA and within-group findings demonstrated consistent effects.

CONCLUSION: The findings demonstrate that BMAA training enhances multiple facets of body-mind functioning, including bodily awareness, mindfulness, positive embodiment, and mental health. As healthcare students encounter cognitive and emotional demands, BMAA may offer a feasible embodied approach for strengthening psychological resilience and adaptive stress management during professional training.

PMID:41983227 | PMC:PMC13072697 | DOI:10.1080/21642850.2026.2656029

Hepatobiliary Surg Nutr. 2026 Apr 1;15(2):36. doi: 10.21037/hbsn-24-433. Epub 2025 Jan 3.

ABSTRACT

BACKGROUND: Gallbladder cancer (GBC) is the most common malignancy of the biliary tract and ranks as the fifth most prevalent cancer of the digestive system. Despite surgical resection, the prognosis for GBC remains dismal, marked by high recurrence rates and poor overall survival (OS). This meta-analysis investigates the impact of adjuvant therapies-including chemotherapy (CT), radiotherapy (RT), and chemoradiotherapy (CRT)-on the prognosis of resectable GBC, aiming to elucidate their clinical benefits.

METHODS: A thorough search of PubMed, Embase, and Web of Science databases was conducted up to April 2024. Studies assessing the effects of adjuvant therapies on OS and disease-free survival (DFS) in patients with resectable GBC were included. Statistical analyses were performed using STATA 17.0 software, with random-effect models employed to address heterogeneity.

RESULTS: The meta-analysis included 23 studies encompassing 36,214 patients. Adjuvant therapy was significantly associated with improved OS [hazard ratio (HR), 0.72; 95% confidence interval (CI): 0.66-0.78]. Specific types of adjuvant therapy showed distinct benefits: CT (HR, 0.80; 95% CI: 0.72-0.88), RT (HR, 0.76; 95% CI: 0.65-0.88), and CRT (HR, 0.56; 95% CI: 0.47-0.67). Subgroup analysis revealed a greater benefit in high-risk patients, including those with more severe tumor-node-metastasis (TNM) staging, R1 resection, and older age (HR, 0.62; 95% CI: 0.50-0.76).

CONCLUSIONS: Adjuvant therapy significantly improves OS in patients with resectable GBC, with CRT offering the most substantial benefit. These results advocate for the inclusion of adjuvant therapy in treatment regimens, particularly for high-risk patients, and underscore the necessity for ongoing research to refine therapeutic approaches.

PMID:41983195 | PMC:PMC13071675 | DOI:10.21037/hbsn-24-433

Braz J Vet Med. 2026 Apr 13;48:e001826. doi: 10.29374/2527-2179.bjvm001826. eCollection 2026.

ABSTRACT

Stomoxys calcitrans is a hematophagous dipteran known as a “stable fly”, capable of parasitizing several animal species. The use of biological agents is an alternative for controlling S. calcitrans, with entomopathogenic nematodes (EPNs) being both resistant and virulent. The present study aimed to evaluate the effect of infection by EPNs subjected to spraying pressure on S. calcitrans larvae in sugarcane straw and vinasse under environmental conditions. Groups of 20 larvae of the stable fly were placed in plastic containers containing one kilogram of autoclaved soil and 200 g of sugarcane straw each. Subsequently, 200 JIs/larvae were sprayed onto the trays with larvae, and emergence traps were placed on the containers. In the control group, there were no EPNs; only vinasse was used. The experiment had three replicates and was monitored daily for 15 days. It was observed that the EPN Heterorhabditis bacteriophora HP88 showed a mortality rate of 33.3%, which was not statistically different from that of the control group (38.3%). The EPNs H. indica LPP30 and H. baujardi LPP7 caused mortality rates of 81.7% and 73.3%, respectively; both being higher than H. bacteriophora HP88 and the control group, but equal to each other under these conditions. It is concluded that H. indica LPP30 and H. baujardi LPP7 were effective against stable fly larvae under environmental conditions, whereas H. bacteriophora HP88 does not demonstrate similar efficacy.

PMID:41983164 | PMC:PMC13075582 | DOI:10.29374/2527-2179.bjvm001826