Background: Cellular immunity as reflected by total lymphocyte count (TLC) has been proven to be related to overall survival rate cancer patients. Lymphocyte proliferation is regulated, to some extent, by nutritional factor. Branched chain amino acid (BCAA) is documented as one of numerous nutrients that play important role in lymphocyte proliferation through its effect on protein synthesis and DNA replication. Many studies describe the correlation between BCAA and TLC in hepatic cancer patients. This study emphasized the observation of that links in head and neck cancer patients. Methods: Eighty-five subjects were included in final analysis, aged 18–75, mostly male, with head and neck cancer who had not received treatment participated in this cross-sectional study at the Dr. Cipto Mangunkusumo General Hospital’s radiation and medical haematology oncology clinic. The BCAAs intake was assessed using a semi-quantitative food frequency questionnaire. Flow cytometry method was used to quantify TLC. Results: Overall, the subjects’ nutritional status mostly was considered normal, with the median intake of 1505 (800–3040) kcal/day of energy and mean of 73.96 ± 23.39 g/day of protein. Moreover, subjects’ average BCAA intake was 10.92 ± 0.48 g/day. Meanwhile, 17.6% of subjects were found to have low TLC level. From thorough analysis, we did not find a strong correlation between BCAA level and TLC (r = 0.235, p = 0.056). Conclusion: In participants with head and neck cancer who had not received chemoradiotherapy, there is no correlation between BCAA intake and TLC. The contribution of non-BCAA amino acids from dietary sources to lymphocyte proliferation requires further investigation. Trial registration: Retrospectively registered, with clinical trial number NCT05226065 on February 7th 2022.

Background: Access to psychological health care is extremely difficult, especially for individuals with severely stigmatized disorders such as eating disorders (EDs). There has been an increase in children, adolescents, and adults with ED symptoms and ED, especially following the COVID-19 pandemic. Computer-based self-help platforms (± associated apps) allow people to bridge the treatment gap and receive support when in-person treatment is unavailable or not preferred. Objective: The aim of this systematic review is to evaluate the effectiveness of computer-based self-help platforms for EDs, some of which may have associated apps. Methods: The proposed systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. This review will report and evaluate the literature concerning the efficacy of self-help platforms for EDs. Articles were obtained from the Ovid MEDLINE, Embase, Global Health, and APA PsycInfo. The inclusion criteria included research with original data and gray literature; research evaluating the efficacy of web-based psychoeducational self-help platforms for EDs; people with an ED diagnosis, ED symptoms, at risk of developing EDs, or from the general population without ED-related behaviors; pre– and post–computer-based ± associated apps intervention clinical outcome of ED symptoms; pre– and post–computer-based ± associated apps intervention associated mental health difficulties; and literature in English. The exclusion criteria were solely guided self-help platforms, only in-person interventions with no computer-based ± associated apps comparison group, only in-person–delivered CBT, self-help platforms for conditions other than eating disorders, systematic reviews, meta-analyses, posters, leaflets, books, reviews, and research that only reported physical outcomes. Two independent authors used the search terms to conduct the initial search. The collated articles then were screened by their titles and abstracts, and finally, full-text screenings were conducted. The Cochrane Risk of Bias 2 tool will be used to assess the risks of bias in the included studies. Data extraction will be conducted, included studies will undergo narrative synthesis, and results will be presented in tables. The systematic review will be submitted to a peer-reviewed journal. Results: The authors conducted a database search for articles published by May 31, 2024. In total, 14 studies were included in the systematic review. Data charting, synthesis, and analysis were completed in Microsoft Excel by the end of July 2024. Results will be grouped based on the intervention stages. The results are expected to be published by the end of 2024. Overall, the systematic review found that computer-based self-help platforms are effective in reducing global ED psychopathology and ED-related behaviors. Conclusions: Self-help platforms are helpful first-stage resource in a tiered health care system. Trial Registration: PROSPERO CRD42024520866; https://tinyurl.com/5ys2unsw International Registered Report Identifier (IRRID): DERR1-10.2196/60165

Background: Following the COVID-19 pandemic, internet-based computer self-help platforms for eating disorders (EDs) became increasingly prevalent as a tool to effectively prevent and treat ED symptoms and related behaviours. This systematic review explored the effectiveness of unguided internet-based computer self-help platforms for EDs. Methods: From inception to the 31^st of May 2024, a systematic search of Ovid MEDLINE, Embase, Global Health, and APA PsycInfo was conducted. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcome quality assessments were conducted according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: 12 RCTs, with a total of 3400 participants, were included. 2 studies explored the effectiveness as primary prevention, 7 as secondary prevention, and 3 as tertiary intervention. The gathered literature demonstrated unguided internet-based computer self-help platforms as effective in reducing ED core symptoms and related behaviours, with psychoeducation, cognitive behavioural, and dissonance-based approaches being the most prevalent approaches. Conclusions: Unguided internet-based computer self-help platforms are effective in the short-term reduction of ED symptoms and associated behaviours and should be implemented in the early stages of a tiered healthcare system for ED treatments. Trial registration: Prospero (CRD42024520866).

Background: Following the COVID-19 pandemic, computer-based self-help platforms for eating disorders (EDs) became increasingly prevalent as a tool to effectively prevent and treat ED symptoms and related behaviours. This systematic review explored the clinical effectiveness of computer-based self-help platforms for EDs. Methods: From inception to the 31 ^st of May 2024, a systematic search of Ovid MEDLINE, Embase, Global Health, and APA PsycInfo was conducted. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcome quality assessments were conducted according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: 14 RCTs, with a total of 4195 participants, were included. 4 studies explored the effectiveness as primary prevention, 7 as secondary prevention, and 3 as tertiary intervention. The gathered literature demonstrated computer-based self-help platforms as clinically effective in reducing ED core symptoms and related behaviours, with psychoeducation, cognitive behavioural, and dissonance-based approaches being the most prevalent approaches. Conclusions: Computer-based self-help platforms are effective in the short-term reduction of ED symptoms and associated behaviours and should be implemented in the early stages of a tiered healthcare system for ED treatments. Trial Registration: Prospero (CRD42024520866).

Background: One study recently suggested that phosphate supplementation might contribute to the occurrence of refeeding edema in patients with restrictive eating disorders (EDs) with severe malnutrition complications. Objective: This commentary aims to provide insight into the study while suggesting a more detailed approach to defining malnutrition, refeeding syndrome, and edema. Main Discussion: There are several diagnostic criteria for diagnosing malnutrition, some of which might overlap with the criteria of refeeding syndrome risks. A precise nutritional and hydration status assessment is needed before starting nutritional therapy for patients with restrictive EDs. With the potential occurrence of refeeding edema during the refeeding practice in these individuals, this commentary discusses the available assessment methods to differentiate edema and other conditions that are related to acute body weight gain. Furthermore, this commentary also outlines the potential pathomechanism involved and provides future recommendations for studies and clinical practice. Conclusions and Implications: Understanding the pathomechanism of the development of refeeding edema is important to ensure patient safety during refeeding practices in patients with restrictive EDs. Further studies are needed to understand this complex mechanism, which includes analyzing the involvement of hyperinsulinemia and capillary leakage as a potential etiology of refeeding edema.

Background: A proportion of patients with anorexia nervosa require compulsory admission due to treatment refusal in the context of high medical or psychiatric risk. Aims: The clinical characteristics and treatment outcomes of patients with anorexia nervosa compulsorily admitted for in-patient care (current and previous) were compared with those of patients admitted voluntarily. The characteristics of their caregivers were also evaluated. Method: This is a secondary analysis of the Transition Care in Anorexia Nervosa Through Guidance Online from Peer and Carer Expertise trial. We included 274 patient–caregiver dyads: 62 on compulsory admission (‘current compulsory’), 48 on voluntary admission with a history of compulsory treatment (‘previous compulsory’) and 164 on voluntary admission without a history of compulsory treatment (‘voluntary’). Baseline demographic and clinical characteristics, and longitudinal clinical outcomes at 3–6 and 9–12 months, were compared across groups. Results: Patients in the current compulsory group had an earlier age of onset, a higher proportion of obsessive–compulsive disorder comorbidity and less motivation and confidence to change compared with the voluntary group. The previous compulsory group showed a longer illness duration, older age and lower body mass index (BMI) compared with the other groups. All groups showed improvement, with similar outcomes at the end of the study except for depression symptoms and BMI. Caregivers had varying levels of distress and caregiving skills at baseline, which had improved by the end of the study. Conclusions: People receiving current or previous compulsory treatment presented with diverse clinical presentations. Further studies are needed to determine whether more individualised approaches improve outcomes in these subgroups. Trial registration number: Trial registration number and data-set information: ISRCTN14644379.