Tag: nevin manimala

J Magn Reson Imaging. 2026 Jul 27. doi: 10.1002/jmri.70466. Online ahead of print.

ABSTRACT

BACKGROUND: Erectile dysfunction (ED) and anxiety have a well-documented bidirectional relationship, with anxiety affecting up to 37% of men with ED. While vascular and endocrine mechanisms are well studied, the central nervous system underpinnings linking anxiety to psychogenic ED (pED) remain unclear.

PURPOSE: To delineate the neural circuitry through which anxiety potentiates erectile dysfunction.

STUDY TYPE: Retrospective case-control study.

POPULATION: About 62 male patients (Age: 45.4 ± 12.3) with confirmed pED and 64 age- and education-matched healthy male controls (Age: 46.1 ± 14.7).

FIELD STRENGTH/SEQUENCE: 3.0 T; T2*-weighted gradient-echo echo-planar imaging sequence.

ASSESSMENT: Task-based fMRI was performed using the Hariri picture-matching task with negative and neutral emotional stimuli; state anxiety was measured with the State-Trait Anxiety Inventory (STAI), and erectile dysfunction severity was assessed using the International Index of Erectile Function (IIEF); all assessments were conducted by trained research staff following standardized protocols.

STATISTICAL TESTS: Whole-brain activation analysis, seed-based Granger causality mapping, and serial mediation analysis were conducted, with significance set at p < 0.05 and family-wise error correction for multiple comparisons.

RESULTS: pED patients showed significant hypoactivation in the right amygdala and occipital cortex during negative emotion processing. In the pED group, amygdala activation significantly correlated with state anxiety (r = -0.54) and ED severity (r = -0.53). Medial prefrontal cortex (mPFC) was identified as the primary upstream regulator of amygdala activity. Elevated state anxiety showed both direct and indirect statistical associations on erectile function via the mPFC-amygdala pathway.

CONCLUSION: Dysfunction of the mPFC-amygdala circuit is associated with the relationship between state anxiety and pED. This circuit represents a novel therapeutic target for pED management.

STAGE OF TECHNICAL EFFICACY: Stage 3.

PMID:42508052 | DOI:10.1002/jmri.70466

Przegl Epidemiol. 2026 Jun 19;80(1):133-148. doi: 10.32394/pe/217294. Epub 2026 Mar 12.

ABSTRACT

BACKGROUND: Condom use effectively prevents sexually transmitted infections (STIs) and unintended pregnancies, and reduces psychological distress associated with concerns about the consequences of sexual activity.

OBJECTIVE: The present study aimed to develop and conduct an initial psychometric evaluation of the Condom Sabotage Victimisation Scale (CSVS-5), a measure designed to capture non-consensual and coercive experiences in which individuals are persuaded or forced to engage in sexual intercourse without condom use.

MATERIAL AND METHODS: We developed an eight-item preliminary scale based on a literature review of condom use resistance (CUR) tactics. Data were collected in Poland in May 2025 as part of the POLARES project. Participation was voluntary and anonymous. Of 1,265 respondents, 767 adults who had been sexually active in the past 12 months met the inclusion criteria. Principal component analysis (PCA) was performed on a test subsample, and confirmatory factor analysis (CFA) on a verification subsample.

RESULTS: Analyses supported a single-factor model of the CSVS-5, comprising five items with statistically significant standardised regression weights (p < 0.001; CFA loadings 0.598-0.962). The scale demonstrated high internal consistency (Cronbach’s α = 0.900). The total score ranges from 0 to 15, with higher values indicating greater victimisation. The mean score for the total sample was 0.45 (SD = 1.86), with means of 0.38 (SD = 1.79) for women and 0.61 (SD = 1.99) for men (p = 0.003). Gender differences unfavourable to women were observed among individuals not in a stable relationship.

CONCLUSIONS: The Condom Sabotage Victimisation Scale (CSVS-5) is a five-item instrument with robust psychometric properties. Its brevity renders it particularly suitable for use in multifaceted observational epidemiological studies, as well as in intervention research focused on STI/HIV prevention and sexual violence.

PMID:42508049 | DOI:10.32394/pe/217294

Int Endod J. 2026 Jul 27. doi: 10.1111/iej.70242. Online ahead of print.

ABSTRACT

BACKGROUND: Condensing osteitis is a radiopaque periapical condition associated with chronic low-grade inflammatory stimuli of endodontic origin. Despite being frequently observed in dental practice, its reported prevalence varies considerably due to methodological and diagnostic inconsistencies across studies.

OBJECTIVES: This systematic review and meta-analysis aimed to estimate the pooled prevalence of condensing osteitis in dentate populations undergoing radiographic examination.

METHODS: A comprehensive search was conducted in PubMed/MEDLINE, Scopus, Web of Science and Embase up to March 2026. Observational studies reporting the prevalence of condensing osteitis were included. Data extraction and risk of bias assessment were performed using the Joanna Briggs Institute checklist. A random-effects meta-analysis with logit transformation was applied. Heterogeneity was assessed using the I² statistic. Subgroup and sensitivity analyses were conducted and certainty of evidence was evaluated using GRADE.

RESULTS: Ten studies including 17 285 individuals were analysed. Based on patient-level data, the pooled prevalence of condensing osteitis was 3.9% (95% CI: 2.8%-4.9%). Substantial heterogeneity was observed (I² = 96%). Subgroup analyses based on age and diagnostic criteria did not explain the heterogeneity. Sensitivity analysis confirmed the robustness of the findings. No evidence of publication bias was detected (Egger’s test, p = 0.761). The overall certainty of evidence was rated as very low.

CONCLUSIONS: Condensing osteitis is a radiographically detectable periapical finding with an estimated prevalence of approximately 4%. However, variability in diagnostic criteria and study methodologies limits the reliability of prevalence estimates. Standardised diagnostic definitions and improved methodological consistency are needed in future research.

REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO): CRD420261354628.

PMID:42508034 | DOI:10.1111/iej.70242

J Magn Reson Imaging. 2026 Jul 27. doi: 10.1002/jmri.70441. Online ahead of print.

ABSTRACT

BACKGROUND: Exercise-induced cardiac remodeling (EICR) may share features with early cardiomyopathy, thereby rendering differentiation challenging with conventional imaging modalities. Identification of novel imaging biomarkers would be useful. Given that intracardiac hemodynamics is closely associated with EICR, its assessment may hold clinical importance. Four-dimensional flow MRI (4D Flow MRI) enables quantification of ventricular flow components, which may provide a complementary hemodynamic perspective alongside conventional structural and functional assessment.

PURPOSE: To characterize biventricular intracardiac flow components in marathon athletes and examine their associations with cardiac structural remodeling.

STUDY TYPE: Prospective.

POPULATION: Fifty-one marathon athletes and 51 age- and sex-matched sedentary controls.

FIELD STRENGTH/SEQUENCE: Steady state free precession cine and 4D Flow MRI sequences at 3.0 T.

ASSESSMENT: Left ventricular (LV) and right ventricular (RV) volumes, myocardial mass, cardiac function, geometry indices, and intracardiac flow components (direct flow, delayed ejection, retained inflow, and residual volume) were quantified and compared between athletes and controls. Exploratory path modeling was used to examine hypothesized relationships among group (athletes vs. controls), cardiac structure, and intracardiac hemodynamics after adjustment for age and sex.

STATISTICAL TESTS: Univariable analysis; Correlation analysis; Exploratory path modeling. A p value < 0.05 was considered significant.

RESULTS: Compared with controls, athletes exhibited significantly lower direct flow in both ventricles (LV: 28.18% ± 7.93% vs. 31.68% ± 6.24%; RV: 29.90% ± 7.04% vs. 33.60% ± 8.33%) and significantly higher residual volume (LV: 25.92% ± 5.30% vs. 22.02% ± 5.24%; RV: 32.45% ± 6.72% vs. 25.38% ± 6.50%). Multiple significant associations were observed between biventricular flow components and cardiac structural/functional metrics. In the path model, all path coefficients were significant and remained so after age/sex adjustment.

CONCLUSION: EICR may involve an intracardiac hemodynamic phenotype characterized primarily by decreased direct flow and increased residual volume. Both of these hemodynamic features are coupled with cardiac structural remodeling.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 2.

PMID:42508032 | DOI:10.1002/jmri.70441

J Ultrasound Med. 2026 Jul 27. doi: 10.1002/jum.70394. Online ahead of print.

NO ABSTRACT

PMID:42508026 | DOI:10.1002/jum.70394

J Clin Oncol. 2026 Jul 27:JCO2601135. doi: 10.1200/JCO-26-01135. Online ahead of print.

ABSTRACT

PURPOSE: Bone metastases (BM) occur in approximately 30% of patients with metastatic renal cell carcinoma (mRCC) and are associated with poor survival and symptomatic skeletal events (SSEs). Radium-223, an alpha-emitting bone-seeking radioisotope, and cabozantinib, a tyrosine kinase inhibitor, have demonstrated activity in BM. RADICAL (Alliance A031801; ClinicalTrials.gov identifier: NCT04071223) evaluated cabozantinib ± radium-223 in mRCC with BM.

METHODS: This phase II trial enrolled patients with mRCC of any histology with ≥1 BM. Patients were randomly assigned 1:1 to cabozantinib ± radium-223, stratified by osteoclast-targeted therapy (OTT), prior therapy, opioid use, and International mRCC Database Consortium (IMDC) risk. The primary end point was SSE-free survival (SSE-FS). Secondary end points included safety, objective response rate (ORR), progression-free survival, and overall survival (OS). A target of 124 evaluable patients was planned, with a prespecified interim futility analysis at 50% of expected SSE-FS events; the trial would stop if the stratified hazard ratio (sHR) > 1.0.

RESULTS: The prespecified interim futility analysis was conducted after 90 patients were enrolled and crossed the futility boundary, leading to closure at 98 patients. The final analysis included all 98 patients. Median age was 63 years, 82.7% had clear cell histology, and 79.6% were using an OTT. IMDC risk was favorable (18.4%), intermediate (67.3%), and poor (14.3%). Median follow-up was 13.1 months. Median SSE-FS for cabozantinib with radium-223 versus cabozantinib was 16.7 versus 17.6 months (sHR, 1.46 [90% CI, 0.86 to 2.51]). Median OS was 28.3 versus 19.7 months (sHR, 1.40 [95% CI, 0.70 to 2.79]). ORR was 19.4% versus 25.0% (P = .78). Grade ≥3 adverse events were similar across arms (69.6% v 75.5%).

CONCLUSION: Radium-223 did not improve SSE-FS when added to cabozantinib. The combination demonstrated a manageable safety profile.

PMID:42507969 | DOI:10.1200/JCO-26-01135

J Clin Oncol. 2026 Jul 27:JCO2502777. doi: 10.1200/JCO-25-02777. Online ahead of print.

ABSTRACT

PURPOSE: Tiragolumab plus atezolizumab has shown encouraging survival outcomes in metastatic non-small cell lung cancer (NSCLC), primarily in patients with PD-L1-high tumors. We further evaluated the combination of tiragolumab plus atezolizumab in the phase III SKYSCRAPER-01 study.

METHODS: Patients with untreated, locally advanced unresectable/metastatic PD-L1-high (by central laboratory testing) NSCLC were randomly assigned 1:1 to receive either tiragolumab (600 mg) plus atezolizumab (1,200 mg) or placebo plus atezolizumab (1,200 mg) intravenously in 21-day cycles until disease progression, loss of clinical benefit, or unacceptable toxicity. Primary end points were investigator-assessed progression-free survival (INV-PFS) and overall survival (OS) in the primary analysis set (PD-L1-high per 22C3 assay).

RESULTS: Five hundred twenty-one patients were randomly assigned to either the tiragolumab plus atezolizumab group (n = 262) or the placebo plus atezolizumab group (n = 259). At the primary PFS analysis (Mar 12, 2022; median follow-up 9.9 months [IQR, 6.2-13.8]), median INV-PFS was 7.0 months (95% CI, 5.6 to 9.8) with tiragolumab plus atezolizumab and 5.6 months (95% CI, 4.4 to 7.0) with placebo plus atezolizumab (hazard ratio [HR], 0.78 [95% CI, 0.63 to 0.97]; P = .02 [nonsignificant]). At the final OS analysis (Sept 24, 2024; median follow-up 17.9 months [IQR, 6.7-39.0]), median OS was 23.1 months (95% CI, 17.7 to 28.8) with tiragolumab plus atezolizumab and 16.9 months (95% CI, 14.6 to 21.3) with placebo plus atezolizumab (HR, 0.87 [95% CI, 0.7 to 1.1]; P = .22 [nonsignificant]). Overall, 41.2% (n = 110/267) and 33.8% (n = 89/263) of patients experienced grade 3-4 adverse events with tiragolumab plus atezolizumab and placebo plus atezolizumab, respectively. Four and two treatment-related deaths occurred in each group, respectively.

CONCLUSION: Tiragolumab plus atezolizumab did not demonstrate a statistically significant INV-PFS or OS benefit over atezolizumab in patients with previously untreated PD-L1-high NSCLC.

PMID:42507968 | DOI:10.1200/JCO-25-02777

Rev Med Chil. 2026 May;154(5):713-720. doi: 10.4067/s0034-98872026000500713.

ABSTRACT

Hypertensive disorders of pregnancy (HDP) are among the leading preventable causes of maternal and perinatal morbidity and mortality. In Chile, regional epidemiological data are scarce despite recognized geographic differences in demographics, comorbidities, and access to care.

AIM: To determine the prevalence and clinical distribution of HDP among pregnant women attended at the Regional Hospital of Arica between 2018 and 2022.

METHODS: We conducted a retrospective, observational, cross-sectional study. All women diagnosed with HDP who delivered at the Juan Noé Crevani Hospital during the study period were included. Cases were classified based on standardized clinical and laboratory criteria into gestational hypertension, preeclampsia (with and without severity criteria), eclampsia, HELLP syndrome, and chronic hypertension. Descriptive statistics were used to analyze demographic, clinical, and perinatal variables.

RESULTS: Among 10,765 deliveries, 666 cases of HDP were identified, yielding a prevalence of 6.2%. The most frequent subtype was preeclampsia/ eclampsia (59.8%), followed by gestational hypertension (16.8%), and chronic hypertension (14.4%). Aymara women exhibited a higher prevalence of preeclampsia (70.6%) than the general group. Only 23.9% underwent first-trimester uterine artery Doppler screening, and prophylactic aspirin use was limited even among high-risk patients. Among those diagnosed with preeclampsia, 61.6% presented at least one severity criterion. The incidence of HELLP syndrome was 2.1%. Subgroups with preeclampsia or superimposed preeclampsia showed higher rates of preterm birth, low birth weight, and neonatal intensive care unit (NICU) admission.

CONCLUSIONS: HDP showed a significant prevalence in northern Chile, with a predominance of severe clinical forms and insufficient implementation of screening and preventive strategies. These findings highlight the importance of strengthening local interventions to improve early detection and prevention, particularly among vulnerable populations.

PMID:42507956 | DOI:10.4067/s0034-98872026000500713

Proc Natl Acad Sci U S A. 2026 Aug 4;123(31):e2602426123. doi: 10.1073/pnas.2602426123. Epub 2026 Jul 27.

ABSTRACT

Declining fertility and the emergence of very low TFR’s in the Asian economies has increased the focus on how to change the direction of the fertility trend. Several countries in Europe and Asia have explored a variety of stimulus packages to increase the overall TFR. In this research we review those policies and examine one of those interventions which has the potential to stimulate fertility-the role of access to housing. The core of housing approaches to stimulating fertility is to make housing more accessible and to use various forms of credit assistance with the aim of making ownership easier and more attractive to young families. The research asks how effective are these approaches to reversing the decline in fertility? And, are they a solution to very low fertility? The results provide some evidence that the focus on housing stimulus packages may increase fertility although most successfully for socioeconomically advantaged households.

PMID:42507922 | DOI:10.1073/pnas.2602426123

Proc Natl Acad Sci U S A. 2026 Aug 11;123(32):e2534106123. doi: 10.1073/pnas.2534106123. Epub 2026 Jul 27.

ABSTRACT

Islands are at the forefront of global environmental change. Biological invasions, land-use change, and climate change are driving population declines and causing irreversible losses in island ecosystems. Although global threat exposure maps have been developed in recent years, they are mostly designed for coarse-grained, continental-extent analyses, often overlooking islands. Here, we assessed the cumulative exposure to biological invasion, land-use change, and climate change by 2050, for more than 16,000 islands worldwide using multiple threat markers. Climate change emerged as a ubiquitous threat, being the dominant threat for 65% of all islands, followed by land-use change (22%) and biological invasions (13%). Islands with the highest cumulative exposure were more likely to be isolated, without historical connection with the mainland. Small and low-elevation islands at low latitudes exhibited greater exposure to climate change, whereas larger, high-elevation islands tended to be more exposed to land-use change. Certain countries and subdivisions, such as Seychelles, Bangladesh, China, French Polynesia, and Micronesia, harbored statistically disproportionate numbers of highly exposed islands, highlighting geographic hotspots of cumulative exposure where conservation efforts might be particularly urgent. Our study indicates that by 2050, most islands will be simultaneously exposed to a triple threat arising from the combined impacts of land-use change, climate change, and biological invasions. This study provides robust quantification of island cumulative exposure to three key drivers of biodiversity loss, making a crucial step toward assessing global biodiversity vulnerability.

PMID:42507912 | DOI:10.1073/pnas.2534106123