Nevin Manimala

Mol Psychiatry. 2026 Apr 18. doi: 10.1038/s41380-026-03619-y. Online ahead of print.

ABSTRACT

The European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA) have raised concerns about a potential link between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and suicide or suicide attempts. We conducted two new-user, active comparator cohort studies. The GLP1-RAs vs sodium-glucose cotransporter-2 (SGLT-2) inhibitors cohort included new users of GLP-1 RAs (n = 83,464) or SGLT-2 inhibitors (n = 78,366), and the GLP1-RAs vs dipeptidyl peptidase-4 (DPP-4) inhibitors cohort included new users of GLP-1 RAs (n = 108,322) or DPP-4 inhibitors (n = 55,411). We also employed a self-controlled case series design to compare suicide, or suicide attempts before and after GLP-1 RA treatment initiation across three time periods. In the cohort analyses patients who initiated GLP-1 RAs did not differ in the hazard ratio (HR) for suicide or suicide attempts from SGLT-2 inhibitor users (HR: 0.93; 95% CI: 0.57-1.52), and GLP-1 RA users had a lower risk of suicide or suicide attempts compared with DPP-4 inhibitor users (HR: 0.58; 95% CI: 0.37-0.91). In the self-controlled case series design, use of GLP-1 RAs was associated with a lower incidence rate ratio (IRR) of suicide or suicide attempts one year after treatment initiation (IRR: 0.45; 95% CI: 0.10-0.50) and 13-24 months after treatment initiation compared with pretreatment. This study showed that use of GLP-1 RAs was not associated with increased incidence of suicide or suicide attempts in either the active comparator new-user design or in the self-controlled case series design.

PMID:42000905 | DOI:10.1038/s41380-026-03619-y

Sci Rep. 2026 Apr 18;16(1):12740. doi: 10.1038/s41598-026-47365-1.

ABSTRACT

This study examines the dynamic relationship between illiteracy and poverty in Egypt over the period 1990-2023 using annual time-series data. The analysis applies both a simple linear regression model and the Autoregressive Distributed Lag (ARDL) framework to distinguish between short-run dynamics and potential long-run relationships. While the linear regression results indicate a statistically significant association between illiteracy and poverty, the ARDL (1,2) specification provides a more appropriate framework for capturing temporal adjustments and dynamic interactions. The ARDL bounds test yields inconclusive evidence regarding long-run cointegration, suggesting that the existence of a stable long-run equilibrium relationship cannot be confirmed with certainty. Consequently, long-run estimates are interpreted as indicative of potential sustained effects rather than definitive equilibrium outcomes. In contrast, the short-run results reveal statistically significant and cumulative effects of illiteracy on poverty. The error correction term is negative and statistically significant (ECM (- 1) = – 0.199), indicating that approximately 19.9% of short-term deviations from the long-run path are corrected each year. Diagnostic and stability tests confirm the robustness and validity of the estimated model. Overall, the findings highlight the importance of short-run dynamics and emphasize education as a critical policy instrument for poverty reduction and sustainable development in Egypt. By focusing on illiteracy as a key determinant, this study provides new empirical insights into the dynamic education-poverty nexus in a developing country context.

PMID:42000812 | DOI:10.1038/s41598-026-47365-1

Gynecol Oncol. 2026 Apr;207S:23-29. doi: 10.1016/j.ygyno.2026.03.010.

ABSTRACT

OBJECTIVE: We examined whether the addition of GLP-1RA to progestin therapy reduced the risk of hysterectomy in patients with endometrial intraepithelial neoplasia (EIN) and endometrial cancer (EC) in the U.S. managed with fertility-sparing management.

METHODS: Women ≤45 years old at EIN/EC diagnosis were identified in the TriNetX Research Collaborative Network (1/1/2017-12/01/2025). Patients initiating GLP-1 RA plus progestins (megestrol acetate, medroxyprogesterone acetate, or levonorgestrel-releasing intrauterine device) formed the GLP-1 RA + progestin group and were compared with the progestin-only group. Groups were 1:1 propensity-score matched (PSM) for demographics, BMI, HbA1c, type 2 diabetes, comorbidities, medication use, healthcare utilization, and EIN/EC. Patients were followed up for 6, 12, and 18 months from treatment initiation until the occurrence of hysterectomy; loss to follow-up; or December 1, 2025. Hazard ratios (HRs) with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Analyses for subgroups, head-to-head comparisons were also performed.

RESULTS: After 1:1 PSM (n = 432 in each group), hysterectomy occurred in 10.2% of the GLP-1RA + progestin group versus 23.4% in the matched progestin-only group (HR 0.41, 95% CI 0.29-0.58) at 18 months, with significant reductions observed as early as 6 months. This protective association was consistent across subgroups, including younger patients (<40 years), EC diagnosis, progestin type (LNG-IUD or oral progestins), and GLP-1RA type (semaglutide or tirzepatide).

CONCLUSION: Adjunct GLP-1 receptor agonist therapy was associated with reduced hysterectomy risk in EIN and EC, supporting prospective fertility-sparing studies.

PMID:42000371 | DOI:10.1016/j.ygyno.2026.03.010

Biol Trace Elem Res. 2026 Apr 18. doi: 10.1007/s12011-026-05102-9. Online ahead of print.

ABSTRACT

Cigarette smoke contains toxic chemicals, such as cadmium (Cd), which accumulate in the body and cause severe health issues. This study examined associations between tobacco smoke exposure on Cd biomarker levels in the US population. A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (2015-2020) for children, adolescents, and adults in the US. The association between serum cotinine levels and blood and creatinine-adjusted urine Cd levels was investigated. Smoke exposure status was categorized by serum cotinine levels into no exposure, light secondhand exposure, heavy secondhand exposure, and active smoking. Survey-weighted multivariable linear regression was conducted to estimate geometric means (GMs) and ratios of GMs, adjusting for covariates. Among adults, compared to individuals with no exposure, those with cotinine concentrations corresponding to the range commonly interpreted as heavy secondhand smoke exposure and active smoking had 1.55 times (95% CI: 1.30, 1.84) and 3.20 times (95% CI: 2.87, 3.57) higher blood Cd levels, respectively, with evidence of a dose-response relationship (p-trend < 0.001). However, for urinary Cd, active smokers showed significantly elevated levels (1.57 times; 95% CI: 1.45, 1.71), while no significant elevation was observed for secondhand smoke exposure. Among children and adolescents, Cd levels did not differ across smoke exposure statuses. Additionally, older age, female sex, lower poverty-income ratio, lower education, and racial minority status were associated with higher Cd exposure. These findings indicate that higher serum cotinine concentrations were associated with higher Cd biomarker levels among adults in the US population.

PMID:41999546 | DOI:10.1007/s12011-026-05102-9

Child Psychiatry Hum Dev. 2026 Apr 18. doi: 10.1007/s10578-026-02005-7. Online ahead of print.

ABSTRACT

Although avoidant/restrictive food intake disorder (ARFID) has been included in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) as a distinct eating disorder category, research on ARFID remains scarce in France, primarily due to a lack of a French tool to assess its diagnosis. The objectives of this study were to provide a validated French-language assessment tool for ARFID and to examine the distribution of different ARFID subtypes (food avoidance based on sensory sensitivity, lack of interest in eating, fear of aversive consequences) in French children and adolescents, in the overall sample and by individuals’ characteristics (i.e., age, gender). Using a translation and back-translation procedure, a French version of the PARDI-AR-Q was administered to 119 parents of children and adolescents with ARFID aged 2 to 16 years. Psychometric analyses supported the existence of the three subtypes with satisfactory internal consistency. Younger children had higher Sensory sensitivity and Lack of interest scores compared to older, while no sex differences were observed for the three subtypes. Hierarchical cluster analysis identified five ARFID profiles (two pure and three combined). These findings support the availability of a reliable French-language instrument for ARFID diagnosis and underscore the importance of recognizing mixed presentations to inform early detection and tailored clinical interventions.

PMID:41999486 | DOI:10.1007/s10578-026-02005-7

Sports Med. 2026 Apr 18. doi: 10.1007/s40279-026-02434-3. Online ahead of print.

ABSTRACT

BACKGROUND: The lasting effects of exercise on brain health in older adults are poorly documented.

OBJECTIVE: The aim of this study was to assess the long-term, post-intervention effects 4 years after a 5-year exercise intervention on brain volumes and cognitive abilities in older adults.

METHODS: A total of 106 older adults (70-77 years at baseline) from the randomized controlled trial (RCT) Generation 100 study randomized into high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), or a control group following national physical activity guidelines for 5 years were included. Post-intervention assessment was performed 9 years after inclusion. Brain magnetic resonance imaging (MRI) and exercise characteristics were acquired at baseline and after 1, 3, 5, and 9 years. Cognitive abilities were assessed with verbal list learning, pattern separation, and odor identification tests at baseline and 9 years. Linear mixed models were used to examine the interaction between exercise group and time on brain volumes. The analyses were repeated, including self-reported exercise behaviors (intensity and duration) as covariates. To examine the general effect of exercise intensity independent of group, a separate model was run across all participants with self-reported exercise intensity as independent variable. For cognition, linear regressions examined associations between exercise group and self-reported exercise intensity on cognitive scores at 9 years, and hippocampal volume loss over time on cognitive scores at 9 years. Whether baseline peak oxygen uptake (VO_2peak) predicted brain volumes and cognitive scores at 9 years was tested with linear regression.

RESULTS: The time × group interaction revealed greater hippocampal volume loss in the HIIT compared with the control group 4 years after the intervention ended, similar to what was found during the intervention. We did not find that self-reported exercise behavior was associated with hippocampal volume over time. Across all participants, greater hippocampal volume loss was associated with poorer verbal memory at 9 years. The test scores on verbal memory and pattern separation did, however, not differ between the groups, but the MICT, and trending for the HIIT group, had higher odor identification scores at 9 years. Higher baseline VO_2peak predicted larger cortical volume and better pattern separation score at 9 years across intervention groups, in line with what was observed during the intervention.

CONCLUSIONS: The control group, which followed the national physical activity guidelines, had the lowest hippocampal volume loss over time, even 4 years after the end of a 5-year exercise intervention in fit older adults. Furthermore, higher baseline VO_2peak provided protective effects on both cortical volume and pattern separation ability across almost a decade, independent of exercise group.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT01666340 (registered 16 August 2012).

PMID:41999477 | DOI:10.1007/s40279-026-02434-3

World J Microbiol Biotechnol. 2026 Apr 18;42(5):224. doi: 10.1007/s11274-026-04810-7.

NO ABSTRACT

PMID:41999466 | DOI:10.1007/s11274-026-04810-7

Clin Exp Dermatol. 2026 Apr 18:llag169. doi: 10.1093/ced/llag169. Online ahead of print.

ABSTRACT

BACKGROUND: Generalized pustular psoriasis (GPP) is a rare, life-threatening skin disease. Spesolimab, an anti-IL-36R monoclonal antibody, has shown efficacy in clinical trials, yet real-world data remain limited.

OBJECTIVE: To evaluate the real-world effectiveness and safety of spesolimab in patients with GPP, and the influence of IL36RN mutation status on treatment response.

METHODS: A prospective study was conducted including patients with GPP treated with a single 900 mg intravenous infusion of spesolimab, with follow-ups at day 7, 1 month, 3 months, and 6 months. Disease severity was assessed using the GPPASI score. Screening of the IL36RN c.80T>C (p.L27P) mutation was performed using Sanger sequencing.

RESULTS: Fourteen patients (n=14) (9 women, 5 men; mean age 39.1 years) were included. The mean baseline GPPASI score was 3.61, which rapidly decreased to 1.3 at day 7, 0.52 at 1 month and 0.29 at 3 months, yet slightly increased to 0.35 at 6 months. The Wilcoxon signed-rank test confirmed a statistically significant decrease in GPPASI over time (p<0.05) from baseline which persisted till the third month. Three relapses occurred during follow-up, and they all responded to acitretin reintroduction. Among the 12 patients tested, 7 carried the IL36RN c.80T>C (p.L27P) mutation in the homozygous state. Treatment response was slightly faster in these patients but there were no statistically significant differences, and the 2 groups converged by the third month. No adverse events were observed.

CONCLUSION: Spesolimab demonstrated rapid and marked efficacy with excellent tolerability in GPP flares, regardless of IL36RN mutation status. Most cases had sustained remission, yet relapse occurred in a minority of patients. This calls for further research to optimize long-term and maintenance therapy.

PMID:41999186 | DOI:10.1093/ced/llag169

Inquiry. 2026 Jan-Dec;63:469580261438330. doi: 10.1177/00469580261438330. Epub 2026 Apr 18.

ABSTRACT

Health care-related tasks (e.g., making appointments, talking to providers) performed by informal caregivers caring for older adults with dementia have become increasingly common, yet the evidence on caregiving task profiles remains fragmented and has not been comprehensively synthesized. This is a systematic review with narrative synthesis of the patterns of health care-related tasks and the characteristics of caregivers who performed them. We searched PubMed, Embase, PsychInfo, Web of Science, and CINAHL databases. The identified tasks were grouped into health and medical care, advocacy and care coordination, and surrogate tasks. We also reported caregiver characteristics. We included 12 studies. Only 5 studies reported on racial and ethnic minority caregivers. Medication management was the most common health and medical care task. Only 1 study reported surrogate tasks, and 2 studies reported caregivers performing advocacy and care coordination tasks. This study is particularly timely given the recent implementation of the Centers for Medicare and Medicaid Services (CMS) Guiding an Improved Dementia Experience (GUIDE) Model, which includes caregiver support and education as core components of dementia care delivery. Systematically characterizing the health care-related tasks performed by dementia caregivers can inform the design, targeting, and evaluation of the GUIDE Model.

PMID:41999183 | DOI:10.1177/00469580261438330

Br J Psychol. 2026 Apr 18. doi: 10.1111/bjop.70076. Online ahead of print.

ABSTRACT

Scholarship on the behavioural immune system suggests that people who perceive themselves as more susceptible to illnesses are more sensitive to disgust, providing an evolutionary advantage to avoid pathogenic stimuli. This sensitivity causes those with greater perceived susceptibility to be biased against outgroup members and avoid those with dissimilar immunological histories. However, the lack of a quantitative review forces researchers to derive arguments from specific empirical observations, rather than holistically drawing from averaged effects across studies. Researchers may over-rely on studies that produced atypical results, causing biases in research on perceived infectability, germ aversion, disgust and outgroup perceptions. To resolve this tension in the literature, we perform a meta-analysis of 74 sources. Our meta-analytic results demonstrate that perceived infectability produces small relations with disgust and non-significant relations with outgroup perceptions, whereas a construct commonly conflated with perceived infectability, germ aversion, produces larger relations with these two outcomes. A meta-analytic structural equation model demonstrates that the indirect effect of perceived infectability on outgroup perceptions via the mediator of disgust is not statistically significant. These findings indicate that, while perceived infectability relates to disgust, the construct does not relate to perceptions of outgroup members, counter to scholarship on the behavioural immune system.

PMID:41999167 | DOI:10.1111/bjop.70076