J Ultrasound Med. 2026 Jul 27. doi: 10.1002/jum.70394. Online ahead of print.
NO ABSTRACT
PMID:42508026 | DOI:10.1002/jum.70394
Tag: nevin manimala
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
Rheumatology (Oxford). 2026 Jul 27:keag309. doi: 10.1093/rheumatology/keag309. Online ahead of print.
ABSTRACT
OBJECTIVES: To compare the psychometric properties (inter-rater reliability, agreement, responsiveness, and measurement error) of the Psoriatic Arthritis Ratingen Score (PARS) and modified Sharp-van der Heijde (SVDH) methods using the Belgian Psoriatic Arthritis (BePas) cohort.
METHODS: Radiographs of hands and feet (baseline T0, follow-ups T1, T2) were independently scored by two blinded readers using SVDH (max 528) and PARS (max 360). Statistical analyses included Intraclass Correlation Coefficient (ICC), Bland-Altman analysis, Standardized Response Mean (SRM), and Smallest Detectable Change (SDC).
RESULTS: Both methods detected positive mean change, primarily between T0 and T1. Inter-rater reliability for absolute scores was high for both (ICC >0.865; baseline ICC: PARS 0.906, SVDH 0.888). For cumulative change scores (ΔT2-T0), inter-rater reliability was low and very similar for both methods (ICC=0.483 for SVDH and 0.485 for PARS). Both methods showed moderate responsiveness over the cumulative interval (two-reader average SRM: PARS 0.571, SVDH 0.531). For both methods and both readers, mean cumulative change scores were smaller than the corresponding SDC values (PARS: 2.8-3.7% of maximum score; SVDH: 2.8-4.1%), indicating that average progression fell below the threshold of reliable individual-level detection. Bland-Altman analysis showed slightly narrower absolute limits of agreement for PARS in selected comparisons, whereas SVDH showed narrower relative limits after normalization to the maximum possible score.
CONCLUSIONS: SVDH and PARS showed broadly comparable psychometric performance for PsA damage assessment. Both methods were robust for cross-sectional scoring but showed important limitations in reliably detecting cumulative change in this low-progression cohort. Neither method demonstrated clear superiority.
PMID:42507901 | DOI:10.1093/rheumatology/keag309
Int J Circumpolar Health. 2026 Dec 31;85(1):2710003. doi: 10.1080/22423982.2026.2710003. Epub 2026 Jul 27.
ABSTRACT
Sauna bathing is a culturally significant practice in Nordic countries and is increasingly recogniced as a multidimensional health-promoting behavior. Although its physiological benefits are well-documented, less is known why people engage in sauna bathing and how they perceive its contribution to health and well-being. To investigate why Swedish women and men engage in sauna bathing and to describe their perceptions of sauna bathing as a health-promoting practice. A descriptive cross-sectional study was conducted using an online questionnaire completed by 588 regular sauna bathers (384 women and 204 men). The questionnaire included closed-ended items on health and sauna habits and open-ended questions exploring motivations for sauna bathing. Qualitative data were analysed using inductive thematic analysis, and quantitative data were analysed using descriptive and analytic statistics. Thematic analysis generated a conceptual model of sauna bathing as a health-promoting practice comprising four interconnected themes: mental recovery, social togetherness, purification and physical health. Mental recovery was the prominent motivation among women, whereas social togetherness ranked highest among men. Participants described sauna bathing as promoting relaxation, reflection, social connection, physical recovery, and a sense of cleanliness and renewal. Women reported significantly better perceived sleep quality and reduced perceived bodily pain following sauna bathing, whereas no corresponding significant changes were observed by men. Sauna bathing was perceived as a multidimensional health-promoting practice integrating psychological, social, cultural, and physical dimensions of health. The findings provide a conceptual understanding of why people engage in sauna bathing and support its potential role as a person-centered health promotion strategy. Prospective studies are needed to confirm these self-reported findings.
PMID:42507891 | DOI:10.1080/22423982.2026.2710003
Am J Clin Oncol. 2026 Jul 23. doi: 10.1097/COC.0000000000001355. Online ahead of print.
ABSTRACT
OBJECTIVES: Anaplastic thyroid carcinoma (ATC) is a rare and aggressive malignancy. The purpose of this study was to update the outcomes of ATC in a large provincial database in a modern cohort.
METHODS: All patients diagnosed with ATC in British Columbia between 2000 and 2022 were included in this retrospective analysis. Charts were reviewed for demographic, staging, treatment, and outcomes data. Statistical analysis was performed using the Kaplan-Meier method for overall survival. The Fine and Gray method was used to determine factors associated with progression.
RESULTS: A total of 127 patients were included, with a median age of 73 years. At diagnosis, 22% had stage IVA, 42% stage IVB, and 36% stage IVC disease. Surgery was performed in 43% of patients, and 66% received radiotherapy. Molecular testing was conducted in 13%, with 5 patients testing positive for BRAF mutations. Chemotherapy was used in 15 patients, either concurrently with radiotherapy or palliatively. Median OS was 5.7 months (stage IVA), 4.3 months (IVB), and 2.5 months (IVC). Improved OS was associated with better ECOG performance status, surgery, radiotherapy, and higher radiation doses (P<0.05). Improved progression-free survival was linked to better ECOG status, absence of metastases, and higher radiation dose (P<0.05). Only 3% of patients survived longer than 3 years.
CONCLUSIONS: In this large population-based cohort, ATC remains associated with poor survival, with outcomes strongly influenced by stage and performance status at diagnosis. Surgery and radiotherapy, particularly higher radiation doses, were associated with improved survival outcomes in selected patients.
PMID:42507837 | DOI:10.1097/COC.0000000000001355
JMIR Hum Factors. 2026 Jul 27;13:e98864. doi: 10.2196/98864.
ABSTRACT
BACKGROUND: Overdose fatality reviews (OFRs) are an important public health tool for developing local overdose prevention strategies by reviewing individual overdose cases. While this approach offers a rich, contextual understanding of drug overdose factors in communities, it examines a small number of cases, providing limited insight into broader population-level risk patterns. To complement OFRs, we developed a real-time dashboard that visualizes trends about 5 key “touchpoints” (ie, interactions with medical and justice services preceding overdose). We then trained local OFR teams to use this dashboard to identify prevention opportunities.
OBJECTIVE: This study examines the integration of population-level data into OFR practices, as well as the tensions that emerge between OFRs’ traditional case-driven review processes and the statistical, population-level analysis typical in public health. We analyze how and when the dashboard was used in meetings, determine the extent to which the data informed recommendations, and identify barriers that prevented the broad uptake of this intervention.
METHODS: We observed 26 OFR meetings across 11 counties in Indiana over 10 months, from November 2024 to September 2025, during which teams conducted case reviews and developed recommendations. We documented instances of dashboard use as well as “missed opportunities,” in which relevant population-level data were available but not incorporated into the discussion. We also conducted semistructured interviews with OFR team members (n=7) to understand their perceptions of the dashboard, including its usefulness, usability, and adoption barriers.
RESULTS: Despite its intended role, the dashboard was rarely integrated into OFR meetings; it was used only 10 times, compared to 114 missed opportunities in which relevant data could have informed discussions. Interviews revealed that this limited uptake was not solely due to usability barriers but reflected a deeper tension between 2 distinct analytic approaches. OFR teams prioritized narrative-driven case reviews that were grounded in empathy, local knowledge, and lived experience. This approach seemed at odds with the population-level visualizations shown in the dashboard, which required statistical abstraction and interpretation. Other barriers identified included limited time and resources, staff turnover, and varying levels of data fluency, which made it difficult for teams to confidently interpret the dashboard despite training.
CONCLUSIONS: The results highlight a tension between case-based and data-driven approaches to overdose prevention. These approaches are grounded in different workflows, values, and motivations, making it challenging for OFR teams to maintain their traditional, empathetic review practices while incorporating population-level trends. Our findings indicate the need for data tools that bridge these approaches, such as visualizations that connect aggregate patterns to individual cases. The results also underscore the need for additional support and training for teams, such as dedicated data specialists who interpret population-level trends and provide insights to augment team discussions and inform prevention strategies.
PMID:42507832 | DOI:10.2196/98864