Nevin Manimala

United European Gastroenterol J. 2026 May;14(4):e70226. doi: 10.1002/ueg2.70226.

ABSTRACT

BACKGROUND AND AIM: Disorders of gut-brain interaction (DGBI) are highly prevalent worldwide. Although the epidemiology of DGBIs in Europe has been previously investigated, data comparing disease prevalence across European regions in relation to sociodemographic and lifestyle factors are lacking. Therefore, this study aimed to assess the prevalence, regional distribution, and associated factors of DGBI in Southern Europe, and to compare findings with other European regions.

METHODS: Data were drawn from the Rome Foundation Global Epidemiology Study (RFGES). A representative sample of 20,420 European adults completed a comprehensive internet-based questionnaire assessing DGBI presence, psychological distress, somatic symptoms, dietary habits, and healthcare utilization. Comparative analyses were conducted between Southern European countries and the rest of the continent (Northern, Western, and Eastern European countries). Multivariate logistic regression identified independent associated factors.

RESULTS: The prevalence of adults with at least one DGBI was significantly higher in Southern Europe than in the rest of Europe (44.0% [42.4-45.5] vs. 39.0% [38.3-39.8]; p < 0.001). Irritable bowel syndrome and functional dyspepsia were more prevalent in Southern Europe than in the rest of Europe. Similar trends were found for functional constipation and functional diarrhea. Individuals with DGBI in Southern Europe showed higher psychological distress but lower somatic symptom burden and lower work productivity and activity impairment. In multivariable models, residence in Southern Europe, female sex, younger age, higher psychological distress, greater somatic symptom burden, higher educational attainment, urban residence and more frequent healthcare utilization were independently associated with DGBI.

CONCLUSIONS: Southern European populations exhibit a higher prevalence of DGBI compared with other European regions. Individuals with DGBI in Southern Europe showed higher rates of psychological distress, whereas those in the rest of Europe showed higher somatic symptom burden, greater work productivity and activity impairment. DGBI rates in Europe appear to be driven by a multifactorial interplay of demographic and psychosocial factors.

PMID:42083911 | DOI:10.1002/ueg2.70226

Plant Cell Environ. 2026 May 5. doi: 10.1111/pce.70587. Online ahead of print.

ABSTRACT

Current allometric methods for photosynthetic-stem (cladode) plants, such as cactus pear (Opuntia spp.), require refinement to be used in field settings in which diverse accessions are grown. We analysed cladode dimensional data using 14 accessions representing four species and two hybrids to quantify statistically significant morphological differences among accessions and derived cross-accession models to approximate cladode fresh weight. A Box model using cladode dimensions (e.g., length, width, thickness and diameter) and factorial combinations of these measures (e.g., length*width*thickness*diameter vs. fresh weight) resulted in the highest coefficient of determination (R² = 0.95 general fit) across all accessions for estimating fresh weight along with parsimony estimates using the Schwarz-Bayes Criterion (SBC), which assesses the most consistent performance on individual accessions. A Fitting-box modelling approach used the measured cladode area captured using ImageJ (R² = 0.93 general fit). Lastly, an Elliptical model used an elliptical approximation for the measured area and performed well over all accessions (R² = 0.94 general fit) while avoiding extensive manual measurements. These models meet or exceed the performance of previously published approaches when applied across morphologically diverse accessions, providing efficient tools for nondestructive estimation of cactus pear biomass under the conditions tested.

PMID:42083905 | DOI:10.1111/pce.70587

J Midwifery Womens Health. 2026 May 5. doi: 10.1111/jmwh.70129. Online ahead of print.

ABSTRACT

INTRODUCTION: Respectful maternity care (RMC) ensures that every childbearing woman is treated with dignity, safety, and respect. Health care professionals play a critical role in RMC but can also contribute to disrespectful and abusive practices, inflicting lasting trauma. Educating pre-service health care learners is one promising strategy for change. As part of our larger Mothering and Albinism research project, we sought timely evidence to develop educational resources supporting RMC for people impacted by albinism.

METHODS: Our international team conducted a rapid scoping review to answer the question, “What curriculum resources are available for integrating RMC into the education of nursing, midwifery, medical, and other health care students, and what are their key pedagogical components and contextual factors shaping implementation?” We searched key databases and online sources for qualitative, quantitative, and mixed-methods studies of RMC education initiatives and curriculum resources relevant to teaching RMC to pre-service learners. Two reviewers screened abstracts/full texts, and data were charted and synthesized using descriptive statistics and content analysis. Our diverse author network was consulted to ensure rigor and relevance for a range of populations.

RESULTS: Our analysis of 25 research reports and 8 curriculum resources produced 5 synthesized categories. The first 4 categories illuminate how RMC education initiatives are conceptualized, their core content, effective pedagogical strategies, and how researchers studied the impact of RMC education. The fifth category addresses contextual influences and the need for taking a systems perspective within RMC education initiatives. Significant gaps remain with few initiatives addressing the unique needs of structurally disadvantaged groups or including trauma-informed, violence-informed, or equity-oriented approaches.

DISCUSSION: RMC education has potential, but it must be paired with systemic change and attention to equity for meaningful change. These findings lay the groundwork for developing context-specific, effective educational resources to support RMC for all women, including those impacted by albinism.

PMID:42083903 | DOI:10.1111/jmwh.70129

Clin Chem Lab Med. 2026 May 6. doi: 10.1515/cclm-2026-0146. Online ahead of print.

ABSTRACT

OBJECTIVES: Dihydropyrimidine dehydrogenase (DPD) phenotyping through uracil and dihydrouracil determination is a well-established approach to identify (partial) DPD deficiencies prior to fluoropyrimidine chemotherapy. However, preanalytical stability has challenged this test for years. This study therefore investigated whether dried blood spots (DBS) can improve preanalytical stability.

METHODS: Uracil, dihydrouracil, and uridine were determined in 6 mm DBS sub-punch extracts by liquid chromatography-tandem mass spectrometry. Paired venous and capillary DBS were collected from 15 healthy volunteers across three days to evaluate venous-capillary DBS differences. The impact of blood spotting, drying and preanalytical stability for up to two weeks was assessed using venous DBS of the same volunteers.

RESULTS: Uracil was elevated in all capillary DBS, with a median of 219 % relative to venous DBS. In addition, the variation between capillary DBS replicates was 29 %, opposed to only 7 % in venous DBS. For dihydrouracil, a small bias of -7 % was observed, while uridine showed no difference, with similar inter-spot variation in venous and capillary DBS. Generation and drying of DBS had statistically significant yet minor effects on all analytes. Venous DBS enhanced preanalytical stability, yielding median uracil levels of 105 % and 107 % after 1 and 2 weeks at room temperature, and no differences for dihydrouracil or uridine relative to overnight dried DBS.

CONCLUSIONS: Capillary DBS are unsuitable for uracil determination in DPD phenotyping owing to poor agreement with venous DBS and substantial variability. Venous DBS, however, demonstrate superior preanalytical stability over liquid samples and may provide a practical solution for managing preanalytical variables.

PMID:42083890 | DOI:10.1515/cclm-2026-0146

Biomed Res Int. 2026;2026(1):e8869056. doi: 10.1155/bmri/8869056.

ABSTRACT

BACKGROUND: Nutritional classification based on body composition in transgender populations poses methodological challenges for health professionals, particularly when sex-based reference criteria are applied. Providing care with a gender-sensitive approach while acknowledging underlying physiological differences remains a complex issue in clinical practice. Therefore, the study aimed to describe differences in body composition classification in transgender women according to the sex selected as reference for analysis.

METHODS: A descriptive, cross-sectional, exploratory study was conducted using purposive sampling. Twenty-five transgender women aged 23-66 years (mean age: 45.8 years), residents of Cali, Colombia, participated in 2022. Anthropometric measurements included weight, height, waist circumference, and body mass index (BMI). Body composition variables assessed by bioelectrical impedance analysis included lean mass, fat mass, skeletal muscle mass, total body water, visceral fat, bioelectrical impedance vector analysis (BIVA), and somatotype. Each participant was evaluated twice using sex-specific reference criteria (sex assigned at birth and female sex). Statistical analyses included the Wilcoxon signed-rank test, chi-square test, and Fisher’s exact test, with a significance level of 5%.

RESULTS: When the same individuals were classified using male and female reference criteria, statistically significant differences were observed in the classification of skeletal muscle mass (p = 0.005), somatotype (p = 0.002), BIVA (p = 0.009), and waist circumference (p = 0.018). No significant differences were observed for BMI or other body composition components.

CONCLUSIONS: The findings of this exploratory study highlight biomedical and methodological challenges in the interpretation of body composition in transgender women when sex-based reference criteria are applied. The results underscore the need for cautious interpretation of anthropometric and bioimpedance outcomes and support the importance of further interdisciplinary research to inform the development of appropriate reference frameworks for the nutritional and clinical assessment of transgender populations.

PMID:42083889 | DOI:10.1155/bmri/8869056

Cancer Prev Res (Phila). 2026 May 5. doi: 10.1158/1940-6207.CAPR-24-0151. Online ahead of print.

ABSTRACT

The National Cancer Institute’s Colorectal Cancer Risk Assessment Tool (NCI-CCRAT), an absolute risk prediction model, was developed using data from US White men and women. The model’s performance has not been assessed for Black Americans, the US racial/ethnic group with the highest colorectal cancer (CRC) incidence. We externally validated the NCI-CCRAT using data from 53,324 Black Women’s Health Study (BWHS) participants aged 40-84 years. We predicted 5-year absolute risks using data from 2001-2015 in three 5-year prediction periods: 2001-2005, 2006-2010, and 2011-2015. To assess model performance, we computed calibration (expected over observed CRC cases, E/O) and discriminatory accuracy (area under the receiver operating curve, AUC). During follow-up, 433 BWHS participants developed CRC. Based on the NCI-CCRAT, 579 CRC cases were expected (E/O=1.34,95% confidence interval [CI]:1.22-1.47). The NCI-CCRAT was well-calibrated in the first 5-year prediction period (2001-2005 E/O=1.10, 95%CI:0.94-1.29), but statistically significantly overestimated risk in later periods. We estimated discriminatory accuracy only for the 2001-2005 prediction period (151 CRC cases) and obtained an age-adjusted AUC=0.62 (95%CI:0.57-0.66). Associations of vigorous physical activity, aspirin/NSAID use, vegetable intake, and body mass index with CRC risk were weaker in the BWHS than in the studies used to develop the NCI-CCRAT. The NCI-CCRAT significantly overestimated the number of CRC cases in BWHS participants, possibly due to population-specific differences in associations of key CRC risk factors. This suggests that future research needs to determine important predictors of CRC risk in Black Americans and to develop a CRC prediction model for Black women.

PMID:42083882 | DOI:10.1158/1940-6207.CAPR-24-0151

Psychol Med. 2026 May 5;56:e126. doi: 10.1017/S0033291726103791.

ABSTRACT

BACKGROUND: The duration of untreated psychosis (DUP) is still considerably long in patients with psychotic disorders worldwide. Social determinants, such as the socioeconomic status, can influence DUP, exacerbating health inequalities in access to timely care. We investigated whether subpopulations with shared characteristics are associated with longer DUP.

METHODS: We performed latent class analyses to investigate whether classes with shared configurations of social and substance use-related risks can be identified in two large cohorts with psychotic disorders: N = 780 patients from the GROUP project and N = 847 patients from the EU-GEI project. Subsequently, we conducted survival analyses to analyze whether identified classes are associated with DUP.

RESULTS: We identified three classes in both samples. Membership of the class with predominantly younger men, higher proportion of cannabis use, and supported living was associated with longer DUP compared with a class with predominantly White ethnicity, higher education, and current employment in GROUP (HR = 1.28, 95% CI: 1.06-1.56, p = .011) and in EU-GEI (HR = 1.27, 95% CI: 1.07-1.51, p = .007). In GROUP, membership of a third class with predominantly White women, without cannabis use, was associated with the shortest DUP (HR = 0.78, 95% CI: 0.63-0.95, p = .016).

CONCLUSIONS: Results suggest that specific populations differ in their risk distributions for prolonged DUP and highlight the importance of considering configurations of social determinants in context. Public mental health programs need to establish their differential impact for diverse populations and facilitate more targeted pathways to care.

PMID:42083874 | DOI:10.1017/S0033291726103791

Psychol Med. 2026 May 5;56:e130. doi: 10.1017/S0033291726103845.

ABSTRACT

BACKGROUND: Methylphenidate is sometimes used to address residual symptoms of major depressive disorder (MDD), but concerns about psychiatric destabilization and limited long-term evidence have constrained its use. We examined the psychiatric safety of methylphenidate in adults with MDD in a large, real-world cohort.

METHODS: Using the TriNetX Global Collaborative Network, we identified adults with MDD who initiated methylphenidate and matched them 1:1 with controls who did not receive methylphenidate. Patients with attention-deficit/hyperactivity disorder, bipolar disorder, mania, or recent psychiatric destabilization were excluded. The primary outcome was a composite of all-cause hospitalization or emergency room visits; secondary outcomes included hospitalization, emergency visits, suicidal behavior, manic episodes, and recurrence of MDD. Hazard ratios (HRs) were estimated with Cox proportional hazards models after propensity score matching.

RESULTS: Of 425,190 eligible patients, 3,211 matched pairs were included (mean age, 55.8 years; 58% female). Over 1 year, the composite outcome occurred less frequently in the methylphenidate group than in controls (574 vs. 694; HR, 0.85; 95% CI, 0.76-0.95). No significant differences were observed for hospitalization, emergency visits, suicidal behavior, manic episodes, or MDD recurrence. Results were consistent across subgroups defined by sex, age, and antidepressant class.

CONCLUSIONS: In adults with MDD, methylphenidate use was associated with a lower risk of hospitalization or emergency visits and was not linked to increased risk of suicidality, mania, or recurrence. These findings support the psychiatric safety of methylphenidate as an adjunctive treatment for selected patients, though longer follow-up is needed.

PMID:42083867 | DOI:10.1017/S0033291726103845

J Alzheimers Dis. 2026 May 5:13872877251394316. doi: 10.1177/13872877251394316. Online ahead of print.

ABSTRACT

BackgroundEarly life adversities can have lifelong consequences for health, including for cognitive functioning and Alzheimer’s disease and related dementias. Moreover, early-life disadvantages stemming from parental death and divorce have been linked with later life social, mental, and physical well-being outcomes, including social isolation. Therefore, loneliness stands out as an intervenable aspect of well-being that may mediate long-term consequences of early life exposure to parental death and divorce for midlife and older adults’ cognitive decline.ObjectiveThe present study aims to determine whether early life exposures to parental death and/or divorce are associated with cognitive functioning in later life, and whether loneliness in midlife mediates such effects.MethodsWe used the 2014-2020 Health and Retirement Study (HRS), 2015 HRS Life History data and longitudinal structural equation modeling to address our research questions.ResultsEarly-life exposure to parental divorce, but not death, was associated with greater loneliness in late midlife and older age, and loneliness predicted more rapid declines to cognitive functioning over time. Mediation was statistically significant (p < 0.05).ConclusionsAlthough racial/ethnic minorities had higher exposure to both parental death and divorce, the effects of parental death and divorce were similar across race/ethnicity. Our results underscore the long-term impacts of parental divorce on well-being and health in adulthood and highlight loneliness as a critical determinant of cognitive declines and disparities in later life.

PMID:42083861 | DOI:10.1177/13872877251394316

Psychol Med. 2026 May 5;56:e125. doi: 10.1017/S0033291726103675.

ABSTRACT

BACKGROUND: Predicting suicide risk remains a challenge. We examined whether neurocognitive performance on implicit associations toward suicide, motor speed, response inhibition, and executive functioning predicts suicide attempt and behavior in high-risk psychiatric patients.

METHOD: Our sample (N = 298) consisted of inpatients (n = 161) and outpatients (n = 83) admitted for a suicide attempt (SA; n = 78), for suicidal ideation (SI; n = 76), or were non-suicidal psychiatric controls (PC; n = 90), and healthy controls (HC; n = 54). Participants were followed for 12 months, with follow-up assessments at 3-, 6-, and 12-months. Neurocognitive tasks were administered at baseline. Clinical symptom measures, suicidality, and electronic health record data were collected at each timepoint. ANCOVA was used to compare groups on neurocognitive performance, and logistic and Cox regressions examined whether neurocognitive performance predicted future actual suicide attempt and suicidal behaviors.

RESULTS: Participants had a mean age of 24.34 years (SD = 3.71). A total of 19 participants made an actual suicide attempt during the study. On neurocognitive tasks at baseline, the SA group had stronger implicit associations with death- and suicide-related words compared to the HC (d = 0.88, p < 0.001) and SI (d = 0.63, p = 0.005) groups and poorer executive functioning than the SI (d = 0.44, p = 0.043) group in multivariate models. Stronger implicit associations with death/suicide predicted higher risk of suicide attempts at the univariate (HR = 1.68 p = 000), but not multivariate level (HR = 1.17 p = 000), while slower motor speed predicted actual suicide attempts (HR = 1.81 p = 000) at the multivariate level.

CONCLUSIONS: Slower motor speed predicts actual suicide attempt and may help identify psychiatric patients who are at high risk for suicidal behavior.

PMID:42083860 | DOI:10.1017/S0033291726103675