Nevin Manimala

J Laparoendosc Adv Surg Tech A. 2026 Mar 27:10926429261435976. doi: 10.1177/10926429261435976. Online ahead of print.

ABSTRACT

BACKGROUND: Rouviere’s sulcus (RS) is widely regarded as an important extra biliary landmark during laparoscopic cholecystectomy (LC), yet its visibility, anatomical variability, and true impact on operative safety remain debated. This study evaluates RS morphology, its incidence of absence, and its influence on operative metrics and complications in a 2-year cohort.

METHODS: A longitudinal observational study was conducted at a single public hospital in the United Arab Emirates, including all elective and emergency LC cases from 2024 to 2025. Electronic medical records and operative videos were reviewed to document RS type, presence or absence, critical view (CV) dissection time, total operative time, and perioperative complications. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, χ²/Fisher’s exact tests, and Spearman correlation.

RESULTS: Among 130 LC cases, RS was identifiable in 85.4%, with 14.6% absence (95% CI: 9.56-21.70). RS morphology (open, slit, scar, and closed) showed no significant effect on CV dissection or operative time (P > .08). However, RS absence was associated with a significantly longer CV dissection time (median 20 versus 18 minutes; P = .030), while the increase in operative time did not reach significance. Demographic factors and comorbidities showed no association with RS type or visibility. Complications were infrequent (4.6%) and unrelated to RS presence. CV dissection time strongly correlated with total operative duration (ρ = 0.834).

CONCLUSIONS: RS was present in most patients, and its absence modestly prolonged CT dissection but did not significantly affect overall operative time or complication rates. While RS can aid orientation, it should complement rather than replace established safety strategies such as the Critical View of Safety and bailout techniques. Multicenter studies are warranted to further clarify the clinical utility of RS morphology.

PMID:41896023 | DOI:10.1177/10926429261435976

Asia Pac J Clin Nutr. 2026 Apr;35(2):360-368. doi: 10.6133/apjcn.202604_35(2).0014.

ABSTRACT

BACKGROUND AND OBJECTIVES: This study aimed to investigate risk factors of malnutrition and the relationship between malnutrition and other geriatric syndromes in patients presenting to a geriatric outpatient clinic in Turkey.

METHODS AND STUDY DESIGN: The data of patients aged ≥65 years seen in a university geriatric outpatient clinic between January 2024 and January 2025 were retrospectively analyzed. Demographic, clinical, and laboratory data and the results of a comprehensive geriatric assessment were noted. The presence of malnutrition in patients was defined according to the Mini Nutritional Assessment-Long Form.

RESULTS: A total of 723 patients (55.9% women) with a median age of 70 years (range, 65-90 years) were included. The prevalence of malnutrition was 14.5% (95% CI 12.1-17.3%) and that of malnutrition risk was 23.9% (95% CI 21.0-27.2%). Malnutrition was found to be associated with advanced age (p = 0.002), female gender (p <0.001), chronic heart failure (p = 0.001), coronary artery disease (p = 0.001), chronic lung disease (p = 0.035), osteoporosis (p = 0.001), and depression (p = 0.001). In geriatric assessment, patients with malnutrition had significantly lower scores for independence in basic and instrumental activities of daily living and cognitive function but higher comorbidity burden, number of drugs used, and depression, sarcopenia, and frailty scores (p <0.001 for all).

CONCLUSIONS: This study showed that malnutrition is highly prevalent in older adults and is associated with chronic diseases and geriatric syndromes such as depression, cognitive impairment, functional dependence, sarcopenia, frailty, and polypharmacy. Therefore, it is essential to provide early nutritional intervention to older individuals who are malnourished or at risk of malnutrition.

PMID:41895839 | DOI:10.6133/apjcn.202604_35(2).0014

Asia Pac J Clin Nutr. 2026 Apr;35(2):347-359. doi: 10.6133/apjcn.202604_35(2).0013.

ABSTRACT

BACKGROUND AND OBJECTIVES: Globally, efforts are underway to evaluate foods and meals by their nutritional value. In Japan, however, there is no comprehensive system for evaluating overall diet quality. The aim of this study is to use the Healthy Eating Index (HEI)-2020, which is based on the American Dietary Guidelines, to evaluate the diet quality of independent elderly Japanese people to consider appropriate methods for evaluating the Japanese diet.

METHODS AND STUDY DESIGN: The subjects were 71 individuals aged 60 years or older who participated in a health examination. HEI-2020 was used to evaluate diet quality, with 13 components scored based on intake per energy unit. Associations of HEI-2020 scores with nutrient intake, food group intake, and dietary reference intakes (DRIs) for Japanese were analysed using statistical methods.

RESULTS: The median HEI-2020 score was 52/100 points. Among the components, the median score was the maximum for Saturated Fats and Added Sugars, but zero for Whole Grains and Refined Grains. The high-score group had significantly lower intake of saturated fatty acids and higher intake of dietary fiber, vitamin K, potassium, and magnesium. In comparison to DRIs, the high-score group had a significantly higher “% meeting the reference value” for several nutrients, including dietary fiber, magnesium, and potassium.

CONCLUSIONS: This study shows that the HEI-2020 can identify nutrients such as dietary fiber and minerals that are lacking in the Japanese population. However, for more effective assessment, there is a need to adjust the reference values to match the intake of Japanese people.

PMID:41895838 | DOI:10.6133/apjcn.202604_35(2).0013

Asia Pac J Clin Nutr. 2026 Apr;35(2):328-336. doi: 10.6133/apjcn.202604_35(2).0011.

ABSTRACT

BACKGROUND AND OBJECTIVES: Diet quality is a key determinant of child growth, yet little is known about its role in stunting-prevalent regions of Indonesia. This study assessed diet quality of young children using a modified Healthy Eating Index (HEI) and examined its associations with growth status and household-maternal factors.

METHODS AND STUDY DESIGN: A cross-sectional study was conducted among 215 children aged 12-59 months in Kulon Progo District, Yogyakarta. Dietary intake was assessed using a semi-quantitative food frequency questionnaire and 24-h recall. The HEI was modified to align with Indonesian dietary guidelines and nutrient adequacy standards. Anthropometry, maternal knowledge, education, and household food security were also measured. Children were classified into tertiles of HEI scores (T1: ≤116, T2: 117-127, T3: ≥128). Associations were analyzed using chi-square, ANOVA/Kruskal-Wallis, and multi-nomial logistic regression.

RESULTS: The mean HEI score was 122 ± 13.3, with 35.8% of children in the low-est tertile. Low intakes of fruits, vegetables, and dairy were the main contributors to poor scores, while grains and fats/oils scored higher. Younger age was independently associated with higher HEI (aOR 0.93; 95%CI 0.88-0.99; p = 0.03). Maternal education, household food security, and maternal knowledge showed no sig-nificant associations.

CONCLUSIONS: Diet quality among children in stunting-prevalent areas remains suboptimal, especially for fruits, vegetables, and dairy. Younger children had better diet quality, underscoring the need for interventions beyond early complementary feeding. Strategies should improve access to diverse, nutrient-rich foods and reduce reliance on processed products.

PMID:41895836 | DOI:10.6133/apjcn.202604_35(2).0011

Asia Pac J Clin Nutr. 2026 Apr;35(2):281-327. doi: 10.6133/apjcn.202604_35(2).0010.

ABSTRACT

BACKGROUND AND OBJECTIVES: In Japan, there are no official dietary guidelines for young children and nutrients may be insufficient on weekends, compared to weekdays at nursery schools. To ensure adequate nutrition, an appropriate dietary evaluation method is required. This study used the Healthy Eating Index (HEI)-2020, which is based on the Dietary Guidelines for Americans, to evaluate the diet quality of Japanese children, examine its validity through associations with nutrient and food group intake, and compare dietary characteristics on weekdays and weekends.

METHODS AND STUDY DESIGN: The participants were 669 children aged 3 to 5 years attending nursery schools across Japan. Relationships of HEI-2020 scores with nutrient and food group intake, and comparisons between weekdays and weekends were evaluated.

RESULTS: The median HEI-2020 score was 50/100, with almost maximum scores for Total Protein Foods, Seafood and Plant Pro-teins, and Added Sugars, while Whole Grains and Refined Grains scored zero. Additionally, the largest score differences between weekdays and weekends were found in Dairy and Greens and Beans. Higher HEI-2020 scores correlated with lower saturated fatty acids intake and higher intakes of dietary fiber, vitamins, and minerals. Weekday scores were significantly higher and less varied than weekend scores.

CONCLUSIONS: HEI-2020 can identify nutrient intake challenges in Japanese children. Greater consumption of Dairy and Greens and Beans-components that showed large weekday-weekend differences-may improve diet quality.

PMID:41895835 | DOI:10.6133/apjcn.202604_35(2).0010

Asia Pac J Clin Nutr. 2026 Apr;35(2):219-230. doi: 10.6133/apjcn.202604_35(2).0005.

ABSTRACT

BACKGROUND AND OBJECTIVES: Weekly iron-folic acid (IFA) supplementation has been implemented in Indonesia to reduce the prevalence of anaemia in adolescent girls. This study aimed to assess the prevalence of anaemia and adherence to weekly IFA supplementation and their associated factors among adolescent girls in senior high schools in two high-stunting-prone areas of Ambon City, Indonesia.

METHODS AND STUDY DESIGN: This cross-sectional study was conducted in August-September 2023, involving 645 adolescent girls enrolled at five senior high schools in two high-stunting-prone areas of Ambon City, namely Poka-Rumah Tiga and Laha Village. The dependent variables were anaemia (i.e., haemoglobin level <12 g/dL) and adherence to weekly IFA supplementation (i.e., consumption of one IFA tablet per week). Factors associated with anaemia and adherence to weekly IFA supplementation were examined using logistic regression.

RESULTS: Of 645 ado-lescent girls surveyed, 19.7% had anaemia, and 19.5% consumed weekly IFA tablets. The likelihood of developing anaemia was associated with respondents with a high level of awareness of anaemia (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.16-2.57). Adherence to taking weekly IFA tablets increased in those with a high level of awareness of IFA supplementation (aOR = 3.88, 95%CI: 2.46-6.10).

CONCLUSIONS: Our study showed that anaemia among adolescent girls represents a moderate to high public health problem, accompanied by low adherence to weekly IFA supplementation among adolescent girls in these areas. Strengthening school-based supplementation, parental engagement, and supply monitoring could enhance programme effectiveness and inform local health policies in Ambon City and other similar settings in Indonesia.

PMID:41895830 | DOI:10.6133/apjcn.202604_35(2).0005

Asia Pac J Clin Nutr. 2026 Apr;35(2):207-218. doi: 10.6133/apjcn.202604_35(2).0004.

ABSTRACT

BACKGROUND AND OBJECTIVES: This cross-sectional study explored the association between dietary patterns and depressive symptoms in middle-aged and older individuals in China.

METHODS AND STUDY DESIGN: A total of 2,956 individuals aged 45-74 years were included in the current data analysis, based on a community-based cross-sectional study from Qingdao, China. Data for this study were derived from field surveys conducted from August 2009 to November 2010. Their mean age was 57.2 ± 8.46 years, and 62.4% were women. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (SQFFQ). Dietary patterns were derived using principal component analysis. Depressive symptoms were assessed using the validated Zung Self-Rating Depression Scale. Logistic regression and restricted cubic spline analyses were conducted to examine the association between dietary patterns and depressive symptoms.

RESULTS: Of the participants, 12.4% had depressive symptoms. These participants were younger, were more likely to be smokers, had a higher body mass index, and had lower income and education levels compared with individuals without depressive symptoms. Four dietary patterns were identified: Balanced, Animal-Pickled vegetables, High sugar-Alcohol, and Animal-Seafood-Egg dietary patterns. The Balanced (odds ratio = 0.53, p < 0.01) and Animal-Seafood-Egg (odds ratio = 0.74, p < 0.01) dietary patterns were negatively associated with depressive symptoms, whereas the Animal-Pickled vegetables dietary pattern was positively associated with depressive symptoms. No significant association was observed for the High sugar-Alcohol dietary pattern. Subgroup analysis revealed stronger inverse effects of Balanced and Animal-Seafood-Egg dietary patterns in women younger than 60 years, nonsmokers, and urban residents compared with in their counterparts. Sensitivity analysis confirmed stability across the continuous and quartile-based variables.

CONCLUSIONS: The Balanced and Animal-Seafood-Egg dietary patterns were associated with lower odds of depressive symptoms, whereas the Animal-Pickled vegetables dietary pattern was associated with higher odds of depressive symptoms.

PMID:41895829 | DOI:10.6133/apjcn.202604_35(2).0004

Phys Rev Lett. 2026 Mar 13;136(10):101001. doi: 10.1103/8g9h-68ms.

ABSTRACT

The distribution of absorption lines in the spectra of distant quasars, called the Lyman-α (Ly-α) forest, is a unique probe of cosmology and the intergalactic medium at high redshifts and small scales. The statistical power of ongoing redshift surveys demands precise theoretical tools to model the Ly-α forest. We address this challenge by developing an analytic, perturbative forward model to predict the Ly-α forest at the field level for a given set of cosmological initial conditions. Our model shows a remarkable performance when compared with the Sherwood hydrodynamic simulations: it reproduces the Ly-α forest flux power spectrum, its cross-correlation with dark matter halos, and the one-point probability distribution function of both fields at the percent level down to scales of a few Mpc. Our work provides crucial tools that bridge analytic modeling on large scales with simulations on small scales, enabling field-level inference from Ly-α forest data and simulation-based priors for cosmological analyses. This is especially timely for realizing the full scientific potential of the Ly-α forest measurements by the dark energy spectroscopic instrument.

PMID:41894784 | DOI:10.1103/8g9h-68ms

Phys Rev Lett. 2026 Mar 13;136(10):105201. doi: 10.1103/48ys-3m6m.

ABSTRACT

The relaxation of many physical systems is constrained by collisions. However, most space and astrophysical plasmas are nearly collisionless, leaving open questions about the pathways of energy transfer and dissipation. In many turbulent plasmas, the electric field takes on the role of energy transfer leading to dissipation. Using measurements from the Magnetospheric Multiscale Mission, we study the statistical properties of the electric field spectrum in the kinetic range of strong turbulence generated by magnetic reconnection in the Earth’s magnetotail. From the inertial to the kinetic range (often called the dissipation range) of scales, we find that turbulent fluctuations develop increasingly non-Gaussian features. The kinetic range contains two regimes with distinct behaviors in the power spectrum and measures of non-Gaussianity. In the subelectron kinetic regime (smaller than the electron gyroradius), the turbulence becomes isotropic and exhibits energy equipartition between the electric field and magnetic field. Our analyses indicate (1) a growing presence of intermittent structures that are expected to lead to enhanced energy dissipation, (2) changes in the electric field dynamics at the transitions between turbulence regimes, and (3) an asymptotic relaxation to a state of energy equipartition in the electromagnetic field in the subelectron kinetic range, where the energy transfer between the magnetic and electric fields appears to be near complete. These results reveal the importance of the electric field in mediating turbulence dissipation and relaxation in collisionless plasmas.

PMID:41894773 | DOI:10.1103/48ys-3m6m

Phys Rev Lett. 2026 Mar 13;136(10):108301. doi: 10.1103/ylbh-8v74.

ABSTRACT

We study spatiotemporal chaos in two-dimensional dense active suspensions using a generalized hydrodynamic model. Increasing activity induces a structural transition marked by the formation of intense vortices and giant number fluctuations at the mesoscale. The flow self-organizes into locally polar-ordered regions coexisting with chaotic domains, producing a bimodal velocity distribution and enhanced correlations. This mixed-state morphology underlies the universal statistical behavior observed beyond a critical activity threshold. Reducing the instability timescale yields similar transitions, showing that both activity and instability act as control parameters for pattern formation. An energy-based order parameter derived from the system’s budget quantifies and unifies these structural transitions across the phase space of activity and instability timescales.

PMID:41894768 | DOI:10.1103/ylbh-8v74