Nevin Manimala

BMC Psychol. 2026 May 8. doi: 10.1186/s40359-026-04729-6. Online ahead of print.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is characterized by social communication deficits and emotional dysregulation. Dialectical behavior therapy (DBT) has shown potential benefits in various psychiatric conditions; however, evidence regarding its effectiveness in individuals with ASD remains limited. This study aimed to evaluate the effects of DBT-based interventions on emotional regulation, suicidal ideation, and depressive symptoms in ASD.

METHODS: Six English and Chinese databases were searched from inception to April 1, 2025. Randomized controlled trials (RCTs) comparing DBT-based interventions with control conditions in individuals with ASD were included. Data were pooled using standardized mean difference (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic, and subgroup analyses were conducted.

RESULTS: Four RCTs involving 375 participants were included. Compared with controls, DBT-based interventions were associated with significant improvements in emotional regulation (SMD = – 0.89, 95% CI: -1.67 to – 0.10) and reductions in suicidal ideation (SMD = – 1.97, 95% CI: -3.02 to – 0.91) and depressive symptoms (SMD = – 2.23, 95% CI: -4.35 to – 0.11). Subgroup analysis indicated that shorter session duration (≤ 60 min) was associated with greater improvements in emotional regulation, whereas no significant effect was observed for longer sessions (> 60 min). No significant effects were found for anxiety.

CONCLUSION: DBT-based interventions show potential benefits in improving emotional regulation, reducing suicidal ideation, and alleviating depressive symptoms in individuals with ASD. However, the findings should be interpreted with caution due to the limited number of trials and substantial heterogeneity. Further large-scale, high-quality RCTs are warranted.

PMID:42104500 | DOI:10.1186/s40359-026-04729-6

Arch Public Health. 2026 May 9. doi: 10.1186/s13690-026-01924-0. Online ahead of print.

ABSTRACT

BACKGROUND: Somalia has one of the lowest childhood immunization coverage rates globally, with only 34.8% of children aged 0-59 months having received at least one vaccine and a high burden of zero-dose children. Immunization uptake is influenced by socioeconomic, maternal, healthcare access, and geographic factors. This study examined determinants of childhood immunization coverage in Somalia to inform equity-focused strategies.

METHODS: A cross-sectional analysis was conducted using nationally representative data from the 2020 Somalia Demographic and Health Survey (SDHS), including 7,373 mother-child pairs. bivariate and multivariable logistic regression models assessed associations between sociodemographic, economic, maternal, healthcare access, and geographic characteristics and child vaccination status, accounting for survey design and confounders.

RESULTS: Overall vaccination coverage was 34.8%. Health facility delivery was the strongest independent predictor (AOR = 1.93; 95% CI:1.68-2.22; p < 0.001). Children from the highest household wealth quintile had higher odds than the poorest (AOR = 2.45; 95% CI:2.00-3.00; p < 0.001). Maternal primary and secondary education were positively associated with vaccination (AOR = 1.58; 95% CI:1.34-1.87 and AOR = 1.94; 95% CI:1.40-2.67; respectively; p < 0.001). Nomadic residence was associated with higher odds compared with rural residence (AOR = 1.69; 95% CI:1.46-1.96; p < 0.001). Compared with infants aged 0-11 months, children aged 12-23 months (AOR = 1.36; 95% CI:1.10-1.69; p = 0.005) and 24-59 months (AOR = 1.33; 95% CI:1.12-1.59; p = 0.001) were more likely to be vaccinated. Lack of radio exposure was associated with lower vaccination odds (AOR = 0.64; 95% CI:0.50-0.82; p < 0.001). Children living in Gedo region had markedly lower odds of vaccination than those in Awdal region (AOR = 0.26; 95% CI:0.17-0.39; p < 0.001).

CONCLUSIONS: Childhood immunization coverage in Somalia remains critically low, reflecting socioeconomic, maternal, healthcare access, and geographic inequalities that require strategies targeting disadvantaged populations and regions.

PMID:42104499 | DOI:10.1186/s13690-026-01924-0

Trop Med Health. 2026 May 8;54(1):82. doi: 10.1186/s41182-026-00967-x.

ABSTRACT

BACKGROUND: The escalation of gastrointestinal tract (GIT) illnesses is now a major global threat, with countries like Uganda having a prevalence of over 31 %. Herbal medicines (HM) are widely used to treat GIT illnesses in many low-resource settings including Sironko District in Eastern Uganda, but their safety remains a grave concern because they often contain bioactive phytochemicals that may cause harmful side effects. In Sironko, herbalists commonly rely on indigenous knowledge rather than formal pharmacological training when prescribing HM hence the potential for adverse reactions linked to toxic phytocompounds is substantial, warranting comprehensive scientific investigation.

OBJECTIVE: To explore plant species used to treat GIT illnesses and perceptions of their adverse effects in Sironko District, to inform safer herbal medicine use.

METHODS: A sample of 70 herbalists was subjected to an ethnobotanical survey using pre-validated semi-structured questionnaires to profile plant species primarily used against GIT illnesses plus awareness and perceptions about the associated side effects. Data were analyzed with descriptive and inferential statistics using STATA version-15.0. Graphs were plotted with GraphPad Prism^® version 9.0.0.

RESULTS: A total of 80 plants species used against GIT infections were documented, mainly in families; Asteraceae and Euphorbiaceae, indicated for treatment and prevention of 24 gastrointestinal illnesses, mostly diarrhea (18.94%), ulcers (11.81%), and stomachaches (8.52%), plus 39 ailments affecting other body systems. Informant consensus factors were high for all disease categories (≥ 0.630), showing homogeneity of ethnomedicinal knowledge. Chenopodium opulifolium, Tithonia diversifolia and Senna didymobotrya were reported to pose the greatest number of side effects, including headache and insomnia. The 70% of participants were unaware that HM can be toxic, 57% were certain that HM do not have side effects, yet those that opposed the need for urgent action against HM adversity were significantly more than participants who perceived it as vital (χ², p < 0.0001).

CONCLUSION: There is a high diversity of plant species used to treat primarily GIT illnesses in Sironko, but many potentially stimulate life-threatening adverse effects such as severe headache and vomiting. These results highlight a need for considerable investment in herbal medicine safety to leverage its optimal use in health promotion and economic development.

PMID:42104496 | DOI:10.1186/s41182-026-00967-x

Parasit Vectors. 2026 May 8. doi: 10.1186/s13071-026-07381-6. Online ahead of print.

ABSTRACT

BACKGROUND: Anaplasma phagocytophilum is an obligate intracellular, tick-borne bacterial pathogen capable of causing disease and even mortality in various mammals, including humans. Non-coding RNAs play important regulatory roles in multicellular organisms, including innate and adaptive immune pathways, which control bacterial, parasitic, and viral infections. However, the global transcriptomic landscape encompassing both ncRNAs and mRNAs in HL-60 cells invaded by A. phagocytophilum remains unexplored.

METHODS: Cell apoptosis was evaluated by flow cytometry at multiple time points after HL-60 cell infection with A. phagocytophilum. Total RNA was extracted and analyzed by RNA sequencing (RNA-seq) to delineate expression alterations of long non-coding RNAs (lncRNAs), microRNAs (miRNAs), and messenger RNAs (mRNAs) at 24 h post-infection (hpi). Bioinformatics methods were employed for gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses to elucidate the potential functions of these differentially expressed genes. Furthermore, an integrated bioinformatics approach was applied to systematically construct a competing endogenous RNA (ceRNA) network involving lncRNAs, miRNAs, and mRNAs.

RESULTS: A. phagocytophilum infection accelerated HL-60 cell apoptosis at multiple time points, with the most significant effect observed at 24 hpi. Transcriptome profiling at 24 hpi identified substantial differential expression, including 487 lncRNAs, 550 mRNAs, and 22 miRNAs with statistically significant changes in expression. Then, expression patterns of eight lncRNAs, eight mRNAs, and seven miRNAs were experimentally validated through reverse transcription quantitative polymerase chain reaction (RT-qPCR), demonstrating strong correlation with RNA-seq results. Bioinformatics analyses revealed significant enrichment of differentially expressed mRNAs in three key pathways: the PI3K/Akt signaling pathway, the actin cytoskeleton regulation pathway and the p53 signaling pathway. Differentially expressed lncRNAs were largely related to the phospholipase D signaling pathway and pathways related to cortisol and aldosterone synthesis/secretion. The altered miRNAs showed predominant enrichment in Rap1 and NF-κB signaling pathways. Notably, computational reconstruction of the lncRNA-miRNA-mRNA ceRNA network identified hsa-miR-4518 and hsa-miR-3609 as central regulatory nodes.

CONCLUSIONS: This comprehensive transcriptome study elucidates complex gene regulatory networks activated in HL-60 cells after A. phagocytophilum invasion, with particular emphasis on pathogen-modulated miRNA signatures that coordinate critical pathways governing host immune responses and microbial survival strategies. These findings elucidate previously uncharacterized molecular mechanisms underlying A. phagocytophilum pathogenesis and may provide actionable targets for novel therapeutics.

PMID:42104495 | DOI:10.1186/s13071-026-07381-6

Knee Surg Relat Res. 2026 May 8;38(1):20. doi: 10.1186/s43019-026-00321-9.

ABSTRACT

BACKGROUND: Anterior cruciate ligament (ACL) injuries are highly prevalent among athletes and continue to pose challenges owing to persistent instability and variable return-to-sport outcomes following reconstruction. Anterolateral ligament (ALL) reconstruction and has been introduced to improve outcomes. Increasing graft diameter was described to enhance biomechanical properties. This study hypothesis was, that ACL reconstruction (ACL-R) combined with ALL reconstruction is superior to a large-sized graft ACL-R.

PURPOSE: To compare outcomes of large-sized (six-strand) hamstring grafts with those of standard-sized (four-strand) grafts combined with anterolateral ligament (ALL) reconstruction in ACL-deficient knees.

METHODS: A total of 82 patients (18-45 years) undergoing ACL reconstruction were randomized to either a large (six-strand) hamstring graft group (group A, n = 41) or a standard-sized (four-strand) graft plus ALL reconstruction group (group B, n = 41). Primary outcomes were knee stability (pivot-shift and Lachman tests) and functional scores [Lysholm and International Knee Documentation Committee (IKDC) scores]. Secondary measures included pain scores, return to sport, and complication rates, with follow-up at 24 months.

RESULTS: The mean diameter of the large-sized graft was 9.5 ± 2.5 mm, while the mean diameter of the standard-sized graft was 8.0 ± 2.0 mm. Both groups demonstrated significant gains in stability and function. Lysholm scores improved from 51 to 94 in group A and from 56 to 98 in group B with no significant difference between both groups (p = 0.418), while IKDC scores rose from 37 to 88 and from 37 to 91, respectively and it was significantly higher in group B (p = 0.036). Negative pivot-shift was observed in 87.8% of group A and 90.2% of group B with no significant intergroup difference (p = 0.841). Return-to-sport at 12 months was 93.5% and 96.1%, respectively with no significant difference (p = 1.00). Graft rupture occurred in 4.8% of group A and 2.4% of group B. Overall complications were low and statistically comparable (p = 1.00).

CONCLUSIONS: Both large hamstring grafts and standard grafts augmented with ALL reconstruction provided significant functional and stability improvements, with no major differences between techniques.

PMID:42104476 | DOI:10.1186/s43019-026-00321-9

J Eat Disord. 2026 May 9. doi: 10.1186/s40337-026-01628-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare preoperative metabolic parameters and body composition in individuals with obesity with and without binge-eating disorder (BED), and to evaluate postoperative short-term weight-loss outcomes in these two groups in the absence of structured preoperative cognitive-behavioral therapy (CBT).

METHODS: This retrospective analysis included 302 participants with obesity from the Western China Bariatric Surgery Cohort. Participants were classified into the BED group and the group without BED based on the Binge Eating Scale (BES) questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. Basal metabolic parameters were assessed via an InBody 770 body composition analyzer, and rigorous follow-up tracking of postoperative weight variations was performed.

RESULTS: A total of 302 individuals with obesity were included, with 151 participants in the BED group and 151 in the group without BED. The proportion of females was significantly higher in the BED group than in the group without BED (p = 0.023). After adjustment for sex, there were no significant between-group differences in preoperative glucose, triglyceride, or total cholesterol levels. Sex hormone levels were comparable between groups in both males and females. Analysis of body composition showed no group differences in overall body weight, BMI, visceral fat area, or basal metabolic rate; however, females with BED exhibited greater leg fat mass (p = 0.037), while a trend toward a larger thigh circumference was observed among males (p = 0.050). In the linear mixed-effects model adjusted for sex and baseline weight, neither the main effect of group nor the group × time interaction was statistically significant, indicating comparable postoperative weight trajectories between the BED and NBED groups from baseline to 2 years after surgery.

CONCLUSION: Individuals with obesity with and without BED showed largely comparable body-composition and metabolic characteristics. Bariatric surgery was associated with similar short-term weight-loss outcomes in individuals with obesity with and without BED, even in the absence of structured preoperative cognitive-behavioral therapy. These findings suggest that bariatric surgery may be an effective short-term weight-loss intervention for individuals with obesity and binge-eating disorder.

PMID:42104469 | DOI:10.1186/s40337-026-01628-4

Alzheimers Res Ther. 2026 May 8. doi: 10.1186/s13195-026-02068-7. Online ahead of print.

ABSTRACT

BACKGROUND: Fluid protein studies in cerebrospinal fluid (CSF) and plasma have provided important insights into neurodegenerative dementias; however, there is a limited investigation of sex-related differences and cross-biofluid relationships. In Alzheimer’s disease (AD), Lewy body dementia (LBD), and frontotemporal dementia (FTD), large-scale, sex-stratified analyses of paired CSF and plasma samples remain scarce. Using the multiplex and ultrasensitive capabilities of NULISAseq™ technology, this study aims to characterize sex- and disease-specific proteomic alterations associated with Central Nervous System (CNS) pathology to explore underlying mechanisms.

METHODS: CSF and plasma samples from 359 individuals with AD, LBD, FTD, and cognitively healthy controls were analyzed using the NULISAseq™ CNS Disease Panel 120. Differential protein expression analyses were conducted across diagnoses and stratified by sex, adjusting for relevant covariates. Spearman’s correlation analyses were performed to assess concordance between CSF and plasma protein levels. All statistical analyses were conducted in R v4.4.3.

RESULTS: Differential protein expression analyses across diagnoses revealed two potential transdiagnostic biomarkers: ICAM1 in CSF and ANXA5 in plasma, showing consistent increases across AD, LBD, and FTD. Sex-stratified analyses in CSF showed modest changes, including higher CCL26, ANXA5, and IL10 in females with AD, and higher IL9, PRDX6, and CX3CL1 in males with AD. In LBD, females exhibited upregulation of ACHE, SFRP1, POSTN in both CSF and plasma. NPTX1 was identified as a potential CSF biomarker for FTD, showing downregulation particularly in males. In contrast, analyses stratified by sex in plasma displayed a larger number of proteins across all dementias, with females showing a higher number of upregulated inflammation-related proteins predominantly involved in cytokine signaling. Overall cross-fluid correlations were restricted to a small subset of proteins, indicating compartment-specific regulation.

CONCLUSIONS: This study represents a large-scale, sex-stratified proteomic analysis of CSF and plasma across major neurodegenerative dementias using NULISAseq™ technology. The findings highlight sex-dependent biomarker patterns, particularly in plasma, and underscore the importance of incorporating sex as a biological variable in dementia research. Future studies should validate candidate proteins in independent cohorts, investigate their functional and mechanistic roles, and assess their utility for biomarker development and sex-tailored therapeutic strategies.

PMID:42104459 | DOI:10.1186/s13195-026-02068-7

BMC Psychol. 2026 May 9. doi: 10.1186/s40359-026-04716-x. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer is one of the leading causes of death worldwide. Oncology nurses play an essential role in the care of oncology patients. Providing care for cancer patients and managing complex treatment processes can be challenging for oncology nurses. The psychological effects of caring for cancer patients and facing their illness and death are often overlooked. The relationships between aging anxiety, job stress, and psychological resilience remain unclear. The aim of this study was to determine the relationship between aging anxiety, job stress, and psychological resilience in oncology nurses.

METHODS: This cross-sectional, correlational and descriptive study was conducted with 220 nurses working in an oncology hospital from December 2023 to February 2024. The Personal Information Form, Relational Aging Anxiety Scale (RASS), Nurse Stress Scale (NSS), and Resilience Scale for Nurses (RSN) were used to collect the data. Descriptive analyses, correlation analysis, and Structural Equation Modeling (SEM) were performed.

RESULTS: Correlation analyses revealed a statistically significant low positive correlation between the relational aging anxiety subscale and NSS scores (r = 0.240, p < 0.05), and a low negative correlation with RSN scores (r = – 0.182, p < 0.05). SEM indicated that RAAS scores were a significant negative predictor of RSN scores (β = -0.214, p < 0.05) and a significant positive predictor of NSS scores (β = 0.608, p < 0.05). No significant direct effect between RSN and NSS scores (β = -0.007, p > 0.05).

CONCLUSIONS: These findings suggest that higher aging anxiety among nurses is associated with greater stress and lower psychological resilience, highlighting the need for comprehensive training programs to reduce aging anxiety and job stress, and to enhance psychological resilience among oncology nurses. Interventions focusing on stress management, emotional regulation, and self-care are recommended. Experimental studies to evaluate the effectiveness of these interventions are encouraged.

PMID:42104429 | DOI:10.1186/s40359-026-04716-x

J Transl Med. 2026 May 8. doi: 10.1186/s12967-026-08252-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Cyclosporine A (CsA) is a widely used immunosuppressive drug, but its long-term use is associated with renal fibrosis. Despite its clinical importance, the molecular mechanisms underlying CsA-induced renal fibrosis remain poorly understood.

METHODS: We used C57BL/6 mice (n = 6 per group) treated with CsA (30 mg/kg/day, gavage) and Boston University mouse proximal tubular (BUMPT) cells (n = 6 per group) exposed to CsA (8 µM). Assessments included Masson’s trichrome staining, Western blot, quantitative real-time PCR, immunohistochemistry, and in situ hybridization. Mechanistic studies employed miR-212-5p mimics and inhibitors, activating transcription factor 6 (ATF6) overexpression, and the endoplasmic reticulum (ER) stress inhibitor 4-phenylbutyric acid (4-PBA). Data are presented as mean ± standard deviation; statistical significance was defined as p < 0.05.

RESULTS: CsA induced significant renal fibrosis in vivo and in vitro, evidenced by increased collagen deposition and elevated expression of alpha-smooth muscle actin (α-SMA), fibronectin, collagen type I and IV, and key profibrotic factors (p < 0.05). RNA analysis revealed that miR-212-5p was markedly upregulated in CsA-treated kidneys, predominantly in renal tubules. Concurrently, ATF6, a protective component of the unfolded protein response (UPR), was significantly downregulated. Bioinformatics prediction and luciferase reporter assays confirmed that miR-212-5p directly targets the 3′ untranslated region of Atf6 mRNA. Functionally, miR-212-5p mimic exacerbated CsA-induced ATF6 suppression and fibrosis, whereas anti-miR-212-5p restored ATF6 expression, attenuated ER stress, and significantly reduced fibrotic markers. Similarly, ATF6 overexpression or ER stress inhibition with 4-PBA ameliorated CsA-induced fibrosis.

CONCLUSIONS: Our findings position miR-212-5p as a previously unrecognized molecular target of CsA and establish the miR-212-5p/ATF6 axis as a central driver of CsA-induced nephrotoxicity. The findings provide new insights into the molecular mechanisms of CsA nephrotoxicity and identify a potential therapeutic target for preventing CsA-induced renal fibrosis.

PMID:42104426 | DOI:10.1186/s12967-026-08252-5

Alzheimers Res Ther. 2026 May 8. doi: 10.1186/s13195-026-02067-8. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between income dynamics-including sustained income level, income changes, and income variability-and early-onset dementia (EOD) has not been well established. This study investigated the association between income dynamics and the risk of EOD.

METHODS: This cohort study included 2,247,461 adults aged 40-60 years who underwent health examinations in 2012 through the Korean National Health Insurance Service, with a median follow-up duration of 5.4 years till 2018. Income status was assessed for 2012 and the 4 preceding years using monthly health insurance premiums, and income-related parameters were derived from this pre-baseline 5-year window. Income variability was defined as the intra-individual standard deviation of four consecutive annual percentage changes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to evaluate the relationship between income dynamics and EOD risk, adjusting for potential confounders.

RESULTS: Sustained low-income status over five years was associated with an increased risk of EOD (HR for 5 years vs. 0 years 1.63, 95% CI 1.49-1.78; P-trend < 0.001), whereas sustained high-income status was associated with a reduced EOD risk (HR for 5 years vs. 0 years 0.55, 95% CI 0.51-0.59; P-trend < 0.001). Notably, higher income variability was linked to a greater risk of EOD (HR for highest vs. lowest quartile 1.37, 95% CI 1.28-1.48; P-trend < 0.001). The decline in income-particularly to the lowest level (Medical Aid beneficiaries)-was associated with an elevated risk of EOD, irrespective of the initial income status.

CONCLUSIONS: Sustained low income, income decline, and greater income variability were associated with higher EOD risk. These findings may help identify socioeconomically vulnerable middle-aged adults for targeted dementia risk assessment and prevention.

PMID:42104420 | DOI:10.1186/s13195-026-02067-8