Clopidogrel Outperforms Aspirin in Reducing Cardiovascular Events Post-PCI: SMART-CHOICE 3 Trial

South Korea: The SMART-CHOICE 3 trial demonstrated that in patients who had completed the standard course of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI), clopidogrel monotherapy (75 mg/day) significantly reduced the 3-year cumulative incidence of adverse events (4.4% vs. 6.6%) and myocardial infarction rates (1.0% vs. 2.2%) compared to aspirin.

In their study published in The Lancet, the researchers noted that stroke rates were similar between the two groups, and there was no significant difference in bleeding risk. These findings highlight the safety and efficacy of clopidogrel as a long-term monotherapy option in high-risk patients post-PCI.

Given the ongoing uncertainty around the optimal long-term antiplatelet strategy for patients undergoing percutaneous coronary intervention, identifying the most effective and safest maintenance therapy remains a clinical priority. While dual antiplatelet therapy is the standard initial approach, the best monotherapy to follow after its completion is still under debate.

To address this, Prof Ki Hong Choi, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, and colleagues designed the study to evaluate and compare the efficacy and safety of clopidogrel versus aspirin monotherapy in patients who had completed the standard duration of DAPT following PCI with drug-eluting stents.

For this purpose, the researchers conducted a multicentre, randomised, open-label trial across 26 sites in South Korea. They enrolled patients aged 19 years or older who were at high risk of recurrent ischaemic events—such as those with a history of myocardial infarction, diabetes requiring medication, or complex coronary lesions—and who had completed the standard duration of DAPT after undergoing PCI.

These patients were randomly assigned in a 1:1 ratio to receive either clopidogrel (75 mg daily) or aspirin (100 mg daily) as oral monotherapy. The primary outcome measured was the cumulative incidence of a composite of all-cause death, myocardial infarction, or stroke in the intention-to-treat population. Adverse events were recorded as part of the secondary endpoints.

Key Findings:

  • A total of 5,542 patients were assessed for eligibility between 2020, and 2023, and 5,506 were randomly assigned to receive either clopidogrel (n=2,752) or aspirin (n=2,754) monotherapy. The median time from PCI to randomisation was 17.5 months.
  • Over a median follow-up of 2.3 years, the primary composite endpoint occurred in 92 patients on clopidogrel and 128 on aspirin, with a 3-year incidence of 4.4% vs 6.6%, respectively (HR 0.71).
  • Death from any cause occurred in 50 patients in the clopidogrel group and 70 in the aspirin group (3-year incidence 2.4% vs 4.0%; HR 0.71).
  • Myocardial infarction was reported in 23 patients on clopidogrel and 42 on aspirin (3-year incidence 1.0% vs 2.2%; HR 0.54).
  • Stroke occurred in 23 patients in the clopidogrel group and 29 in the aspirin group (3-year incidence 1.3% in both; HR 0.79).
  • Bleeding risk was similar between the two groups, with a 3-year incidence of 3.0% in both arms (HR 0.97).
  • Clopidogrel was not linked to a higher rate of adverse events compared to aspirin.

“Among high-risk patients who had completed the standard duration of dual antiplatelet therapy following PCI, clopidogrel monotherapy significantly lowered the cumulative risk of death, myocardial infarction, and stroke compared to aspirin, without increasing bleeding risk,” the authors concluded.

Reference:

Choi KH, Park YH, Lee JY, Jeong JO, Kim CJ, Yun KH, Lee HC, Chang K, Park MW, Bae JW, Doh JH, Cho BR, Kim HY, Kim W, Kim U, Rha SW, Hong YJ, Lee HJ, Ahn SG, Kim DI, Cho JH, Her SH, Jeon DS, Han SH, Lee JB, Lee CW, Kang D, Lee JM, Park TK, Yang JH, Lee SY, Choi SH, Gwon HC, Song YB, Hahn JY; SMART-CHOICE 3 investigators. Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial. Lancet. 2025 Apr 12;405(10486):1252-1263. doi: 10.1016/S0140-6736(25)00449-0. Epub 2025 Mar 30. PMID: 40174599.

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Spot Capillary HbA1c Testing Boosts Type 2 Diabetes Detection in High-Risk Patients, Study Finds

China: A recent cluster randomized controlled trial has demonstrated that point-of-care capillary HbA1c (POC-cHbA1c) testing can significantly improve early detection of type 2 diabetes (T2D) in high-risk individuals within primary care.

“Compared to traditional venous HbA1c testing, POC-cHbA1c testing led to twice the screening uptake, delivered quicker results, reduced the need for follow-up visits, and identified more previously undiagnosed cases of type 2 diabetes,” the researchers reported in BMC Medicine.

The delayed diagnosis of type 2 diabetes increases the risk of complications, making the high number of undiagnosed cases in Hong Kong a growing public health concern. Point-of-care capillary HbA1c testing offers a convenient, timely, and comparably accurate alternative to traditional venous HbA1c (vHbA1c) testing for diabetes screening. However, evidence from randomized trials is limited.

Linda Chan, The Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong SAR, China, and colleagues evaluated the effectiveness of a two-step active opportunistic screening approach using POC-cHbA1c versus usual care with vHbA1c and multiple clinic visits in identifying type 2 diabetes among at-risk patients in primary care. The main outcomes included comparing diabetes detection rates and testing uptake between the two groups.

For this purpose, the researchers conducted a cluster randomized controlled trial across eight General outpatient clinics between June 2022 and January 2024, using a two-step active opportunistic screening approach. In the first step, 852 at-risk individuals were identified during routine primary care visits based on specific inclusion and exclusion criteria. In the second step, these patients underwent either point-of-care capillary HbA1c (POC-cHbA1c) testing in the intervention group or venous HbA1c (vHbA1c) testing in the control group.

Those with HbA1c levels ≥5.6% were offered a confirmatory oral glucose tolerance test. Clinics were randomized using a computer-generated sequence, and multilevel logistic regression assessed the impact of the intervention on testing uptake, accounting for patient factors and clinic-level clustering.

The following were the key findings of the study:

  • The uptake rate for POC-cHbA1c testing was significantly higher than for vHbA1c (76.0% vs 37.5%; OR = 7.06).
  • POC-cHbA1c identified a greater proportion of type 2 diabetes cases (4.2% vs 1.4%).
  • Detection of pre-diabetes was also higher with POC-cHbA1c (11.8% vs 6.9%).
  • Combined detection of type 2 diabetes and pre-diabetes was more likely with POC-cHbA1c (OR = 1.99).
  • The number needed to screen to identify one additional case of type 2 diabetes using POC-cHbA1c versus vHbA1c was 61.

“The study highlights the strong potential of POC-cHbA1c testing as an effective screening strategy for type 2 diabetes in primary care. With significantly higher uptake and improved detection rates compared to traditional venous HbA1c testing, POC-cHbA1c can help expand screening coverage, accelerate diagnosis, and support earlier intervention among at-risk individuals,” the authors concluded.

Reference:

Chan, L., Yu, E.Y.T., Wan, E.Y.F. et al. Improving type 2 diabetes detection among at-risk individuals – comparing the effectiveness of active opportunistic screening using spot capillary-HbA1c testing and venous HbA1c testing: a cluster randomized controlled trial. BMC Med 23, 190 (2025). https://doi.org/10.1186/s12916-025-04007-z

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Nasal Etripamil Nearly Twice as Effective as Placebo in Halting PSVT Episodes, Trial Finds

USA: A recent study published in JAMA Cardiology revealed that self-administered etripamil was almost twice as effective as placebo in terminating paroxysmal supraventricular tachycardia (PSVT) episodes within 30 minutes.

The recent secondary analysis of data from two phase 3 randomized clinical trials has shed light on the potential of self-administered intranasal etripamil in reducing emergency department (ED) visits among individuals with PSVT. This fast-acting calcium channel blocker, delivered through the nasal route, is being evaluated for its efficacy in managing acute episodes of atrioventricular-nodal-dependent PSVT outside hospital settings.

Paroxysmal supraventricular tachycardia is characterized by sudden, rapid heart rhythms often requiring immediate intervention to restore normal rhythm. Traditional oral therapies have been limited by delayed onset and potential side effects, making rapid-acting alternatives an area of clinical interest.

The analysis combined data from the NODE-301 part 1 and its continuation study, RAPID, which were double-blind, placebo-controlled, and event-driven. Participants were trained to self-administer a 70 mg dose of etripamil at the onset of PSVT symptoms. In the RAPID extension, a second dose was permitted 10 minutes after the first if symptoms persisted. Patients were advised to seek emergency care if symptoms continued beyond 30 minutes.

The key findings of the study were as follows:

  • The pooled analysis included 340 patients, with 206 receiving etripamil and 134 receiving a placebo. The average age of participants was 54.7. Women made up nearly 70% of the study population.
  • Before taking the study drug, 370 patients attempted vagal maneuvers, but only 4.6% achieved PSVT termination using this method.
  • PSVT episodes were resolved within 30 minutes in 57.8% of patients who used etripamil, compared to 32.1% in the placebo group.
  • Only 13.6% of patients in the etripamil group required an emergency department visit, compared to 22.4% in the placebo group.
  • This corresponded to an 8.8% absolute and 39% relative reduction in ED visits, with a relative risk of 0.61.
  • Etripamil was generally well-tolerated, with most side effects limited to the nasal administration site.
  • No serious adverse events were reported in patients who received etripamil.

Given that PSVT affects approximately 1 in 300 people in the U.S. and leads to substantial healthcare utilization, the availability of an effective at-home treatment could significantly ease the burden on emergency services. The analysis suggests that treating 12 patients with etripamil could prevent one ED visit.

While the results are promising, Sean D. Pokorney, Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, and colleagues note that future research is needed to explore further the impact of etripamil on long-term healthcare outcomes and its broader applicability. Pooling data from multiple studies, though necessary to achieve statistical power, also presents certain limitations that future investigations may help address.

Reference:

Pokorney SD, Camm AJ, Dorian P, et al. Self-Administered Etripamil and Emergency Department Visits in Supraventricular Tachycardia: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. Published online April 09, 2025. doi:10.1001/jamacardio.2025.0417

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Healthy nutrition and physical lifestyle choices lower cancer mortality risk for survivors, new ACS study finds

In 2022, the American Cancer Society (ACS) updated its nutrition and activity guidelines for cancer survivors, recommending they avoid obesity, stay physically active, eat a healthy diet, and limit alcohol intake. New research by ACS scientists shows a lifestyle aligned with these guidelines is associated with a lower mortality risk among non-smoking survivors of obesity-related cancers in the United States. Survivors who maintained a healthy lifestyle both before and after their diagnosis-or those who improved their habits after diagnosis-also had a lower mortality risk. The study is out today in the Journal of the National Cancer Institute (JNCI).

“A cancer diagnosis often motivates people to think about how they can live healthier lives. Many survivors want to know what lifestyle changes they can make to improve their chances of living longer,” said Dr. Ying Wang, senior principal scientist, epidemiology research at the American Cancer Society and lead author of the study. “These findings underscore how making the right lifestyle choices truly affects cancer survival.”

Researchers analyzed the lifestyle habits of non-smoking participants from the Cancer Prevention Study-II Nutrition Cohort diagnosed with obesity-related cancers between 1992 and 2002 through 2020. Post-diagnosis adherence to ACS guidelines-body mass index (BMI), physical activity, diet, and alcohol consumption—was scored on a scale from 0 to 8. Models were used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Study results showed among 3,742 cancer survivors (average age 67.6 years) with a median follow-up of 15.6 years, 2,430 deaths occurred. Survivors with a score of 6-8 had a 24% lower risk of all-cause mortality (HR = 0.76; 95% CI = 0.68 to 0.85), a 33% lower risk of cardiovascular disease mortality (HR = 0.67; 95% CI = 0.54 to 0.83), and a 21% lower risk of cancer-specific mortality (HR = 0.79; 95% CI = 0.64 to 0.97) compared to those with a score of 0-3. Higher BMI and physical activity scores were associated with lower all-cause mortality. Compared to survivors with a consistently low ACS guideline score (less than 5) both before and after diagnosis, those with a consistently high score (five or more) had lower all-cause and cardiovascular disease mortality. Additionally, survivors who improved their score from low to high had lower all-cause mortality.

Reference:

 Ying Wang et al, Following the American Cancer Society guideline for cancer survivors and obesity-related cancer survival, JNCI: Journal of the National Cancer Institute (2025). DOI: 10.1093/jnci/djaf051

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Extreme Heat Poses Threat to Mental Health, reveals research

Rising temperatures across Australia could increase the burden of mental and behavioural disorders (MBD) by almost 50 per cent by 2050, according to a new study from the University of Adelaide. The research highlights the urgent need to act now to protect mental health as the climate warms.

Published in Nature Climate Change, the study shows that high temperatures contributed to an annual loss of 8458 disability-adjusted life years (DALYs), representing 1.8 per cent of total MBD burden in Australia. Young Australians aged 15 to 44 are particularly affected, with most losses linked to living with poor mental health.

“The detrimental impacts of climate change on good mental health and emotional states have been increasingly recognised worldwide, and it’s only going to get worse unless we act,” said lead author Professor Peng Bi, from the University’s School of Public Health.

MBDs encompass a broad spectrum of symptoms associated with distress or impairment in important functional areas, including an individual’s emotional regulation, cognition or behaviour, and include anxiety, depressive, bipolar affective, schizophrenia, alcohol, drug use and other mental and substance use disorders.

“From mild distress to serious conditions like schizophrenia, rising temperatures are making things harder for millions,” said Professor Bi.

The study, based on data from the Australian Burden of Disease database, found that warmer regions, like those closer to the equator, face higher risks.

The Northern Territory had the highest predicted relative risk as well as highest average threshold temperature while South Australia and Victoria had the highest proportion of burden attributable to high temperature, with 2.9 per cent (62.6 DALYs per 100,000) and 2.2 per cent (51.1 DALYs per 100,000), respectively.

“These results underscore the crucial role of policymakers in developing focused public health interventions to minimise the emergence of mental health impacts of climate change, given its significant human, social and financial consequences,” said Professor Bi.

“About 8.6 million Australians aged 16 to 85 will experience an MBD within their lifetime. Factors like income, access to healthcare, and local conditions shape how heat affects mental health, with some areas hit harder than others.”

“Our findings show that climate change will drive up mental health challenges beyond what population growth alone would cause,” said first author Dr Jingwen Liu.

“Young people, who often face these issues early in life, are especially at risk as the climate crisis worsens.”

The researchers call for immediate action, including a heat-health action plans to prepare healthcare systems for rising mental health needs, localised solutions, like community programs and green spaces to build resilience and support for vulnerable groups, ensuring those most at risk get the care they need during hot periods.

“Policymakers must step up with targeted, people-centred strategies to protect mental health as temperatures climb,” said Professor Bi.

Reference:

Liu, J., Varghese, B.M., Hansen, A. et al. Increasing burden of poor mental health attributable to high temperature in Australia. Nat. Clim. Chang. (2025). https://doi.org/10.1038/s41558-025-02309-x.

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Baricitinib Shows Long-Term Safety in Severe Alopecia Areata: 4-Year Trial Data

USA: In a significant advancement for the treatment of severe alopecia areata (AA), long-term data from two phase III clinical trials—BRAVE-AA1 and BRAVE-AA2—have confirmed that baricitinib maintains a consistent and favorable safety profile even after up to four years of use.

The findings, published in the American Journal of Clinical Dermatology, highlight that the drug is well-tolerated over extended periods with low incidence rates of serious adverse events (IR 2.6) and no reported cases of serious infections, cardiovascular events, deep vein thrombosis, pulmonary embolism, or death. Additionally, rates of herpes zoster (IR 1.9) and malignancies (IR 0.2) remained stable throughout the follow-up period, reinforcing the long-term safety of baricitinib for patients managing this chronic autoimmune condition.

Baricitinib, a Janus kinase (JAK) inhibitor, is one of the first systemic treatments approved for severe alopecia areata and works by targeting the underlying immune dysfunction associated with the condition. Brett King, Department of Dermatology, Yale School of Medicine, New Haven, CT, USA, and colleagues present pooled safety findings on baricitinib treatment for severe alopecia areata based on data from the BRAVE-AA1 (Phase II/III) and BRAVE-AA2 (Phase III) trials, encompassing both the long-term extension and bridging extension phases.

For this purpose, the researchers assessed safety data from two groups: patients on continuous baricitinib (2 mg or 4 mg) and all patients who received any dose during the trials. They evaluated treatment-emergent adverse events, key safety concerns, and lab abnormalities. Incidence rates per 100 patient years were calculated based on risk duration. Data cutoffs were May 22, 2023 (BRAVE-AA1), and May 8, 2023 (BRAVE-AA2), with a follow-up of at least 152 weeks.

The key findings of the study were as follows:

  • Safety data included 1,303 patients treated with baricitinib, accounting for 2,789.7 patient-years of exposure (median duration: 825 days; maximum: 1,460 days).
  • Most treatment-emergent adverse events were mild to moderate in intensity.
  • The incidence rate (IR) of serious adverse events was low at 2.6 per 100 patient-years.
  • Discontinuation due to adverse events occurred at a low rate (IR = 1.7).
  • These rates were consistent with previously reported data through at least 104 weeks.
  • No new cases of serious infections, opportunistic infections, major cardiovascular events, deep vein thrombosis, or pulmonary embolism were reported during an additional year of follow-up.
  • Rates of non-melanoma skin cancer (IR = 0.1) and other malignancies (IR = 0.2) remained stable.
  • Herpes zoster incidence remained consistent with earlier data (IR = 1.9).
  • Laboratory test changes showed stable trends over time.
  • There were no deaths in either BRAVE-AA1 or BRAVE-AA2 trials.

“The long-term safety findings from the BRAVE-AA1 and BRAVE-AA2 trials align with earlier data from the baricitinib clinical program for alopecia areata, showing no new safety concerns or signals even with treatment durations extending up to four years,” the authors concluded.

Reference:

King, B., Mostaghimi, A., Shimomura, Y. et al. Safety of Baricitinib in Adults with Severe Alopecia Areata from Two Phase III Trials Over a Median of 2.3 Years and Up to 4 Years of Treatment. Am J Clin Dermatol (2025). https://doi.org/10.1007/s40257-025-00932-0

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Postoperative Rehabilitation demonstrated preventive role against relapse after osseous temporomandibular joint ankylosis surgery: Study

A new study published in the journal of BMC Oral Health showed that during the unusually long clinical follow-up period of 24 months, postoperative rehabilitation was found effective for prevention of  recurrence following TMJA surgery.

Temporomandibular joint ankylosis (TMJA) is a disorder in which the temporomandibular joint (TMJ) becomes permanently stuck in a forced position due to an intracapsular lesion, resulting in significantly reduced mandible motion. As a result, not only severe trismus, but also masticatory function and facial deformities might impair aesthetics in afflicted people.

TMJA is classified into fibrous ankylosis and bony ankylosis, with the latter frequently causing a severe condylar dysfunction and impairing quality of life (QOL). Gap arthroplasty (GA), which involves excising any bony adhesion between the joint space and mandibular condyle without inserting it into the resulting gap, and interpositional gap arthroplasty (IPG), which involves creating a gap and then inserting an artificial material or temporalis myofascial flap (TMF) for example, are two related surgical procedures that have been reported.

The goal of surgical therapy for TMJA is to improve patient quality of life by reducing ankylosis, restoring condylar function, avoiding ankylosis recurrence, and enhancing facial attractiveness. Thus, this study sought to clarify and analyze the association between the operational method, the rehabilitation time, and maximum incisal opening (MIO), with an emphasis on mouth opening following surgical treatment for TMJA.

12 patients who had surgery for gap or interpositional arthroplasty were included. The course of maximal incisal opening in patients was split by surgical procedure, gap size, and rehabilitation duration, with a focus on relapse of maximal incisal opening. The average recurrence of maximum incisal opening following surgery in patients with a gap size ≥ 15 mm was 12.0 ± 11.2 mm, whereas in those with a gap size < 15 mm was 8.9 ± 12.6 mm.

The average relapse of maximum incisal opening following surgery in patients with gap arthroplasty was 12.3 ± 7.6 mm, whereas those with interpositional arthroplasty was 7.5 ± 15.2 mm. After surgery, patients with less than 12 months of rehabilitation had an average relapse of 14.1 ± 10.7 mm, whereas those with more than 12 months had an average recurrence of 7.4 ± 16.3 mm.

Overall, the findings of this retrospective study over a relatively long clinical follow-up period of 24 months demonstrate the relevance of postoperative rehabilitation in avoiding recurrence following TMJA surgery.

Source:

Ezoe, Y., Nogami, S., Otake, Y., Chiba, M., Takahashi, T., & Yamauchi, K. (2025). Clinical course of jaw function recovery following surgical treatment in patients with temporomandibular joint ankylosis- correlation with mouth opening rehabilitation. BMC Oral Health, 25(1), 423. https://doi.org/10.1186/s12903-025-05806-9

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Golden eyes: How gold nanoparticles may one day help to restore people’s vision

 A new study by Brown University researchers suggests that gold nanoparticles-microscopic bits of gold thousands of times thinner than a human hair-might one day be used to help restore vision in people with macular degeneration and other retinal disorders.

In a study published in the journal ACS Nano and supported by the National Institutes of Health, the research team showed that nanoparticles injected into the retina can successfully stimulate the visual system and restore vision in mice with retinal disorders. The findings suggest that a new type of visual prosthesis system in which nanoparticles, used in combination with a small laser device worn in a pair of glasses or goggles, might one day help people with retinal disorders to see again.

“This is a new type of retinal prosthesis that has the potential to restore vision lost to retinal degeneration without requiring any kind of complicated surgery or genetic modification,” said Jiarui Nie, a postdoctoral researcher at the National Institutes of Health who led the research while completing her Ph.D. at Brown. “We believe this technique could potentially transform treatment paradigms for retinal degenerative conditions.”

Nie performed the work while working in the lab of Jonghwan Lee, an associate professor in Brown’s School of Engineering and a faculty affiliate at Brown’s Carney Institute for Brain Science, who oversaw the work and served as the study’s senior author.

Retinal disorders like macular degeneration and retinitis pigmentosa affect millions of people in the U.S. and around the world. These conditions damage light-sensitive cells in the retina called photoreceptors-the “rods” and “cones” that convert light into tiny electric pulses. Those pulses stimulate other types of cells further up the visual chain called bipolar and ganglion cells, which process the photoreceptor signals and send them along to the brain.

This new approach uses nanoparticles injected directly into the retina to bypass damaged photoreceptors. When infrared light is focused on the nanoparticles, they generate a tiny amount of heat that activates bipolar and ganglion cells in much the same way that photoreceptor pulses do. Because disorders like macular degeneration affect mostly photoreceptors while leaving bipolar and ganglion cells intact, the strategy has the potential to restore lost vision.

In this new study, the research team tested the nanoparticle approach in mouse retinas and in living mice with retinal disorders. After injecting a liquid nanoparticle solution, the researchers used patterned near-infrared laser light to project shapes onto the retinas. Using a calcium signal to detect cellular activity, the team confirmed that the nanoparticles were exciting bipolar and ganglion cells in patterns matched the shapes projected by the laser.

The experiments showed that neither the nanoparticle solution nor the laser stimulation caused detectable adverse side effects, as indicated by metabolic markers for inflammation and toxicity. Using probes, the researchers confirmed that laser stimulation of the nanoparticles caused increased activity in the visual cortices of the mice-an indication that previously absent visual signals were being transmitted and processed by the brain. That, the researchers say, is a sign that vision had been at least partially restored, a good sign for potentially translating a similar technology to humans.

For human use, the researchers envision a system that combines the nanoparticles with a laser system mounted in a pair of glasses or goggles. Cameras in the goggles would gather image data from the outside world and use it to drive the patterning of an infrared laser. The laser pulses would then stimulate the nanoparticles in people’s retinas, enabling them to see.

The approach is similar to one that was approved by the Food and Drug Administration for human use a few years ago. The older approach combined a camera system with a small electrode array that was surgically implanted in the eye. The nanoparticle approach has several key advantages, according to Nie.

For starters, it’s far less invasive. As opposed to surgery, “an intravitreal injection is one of the simplest procedures in ophthalmology,” Nie said.

There are functional advantages as well. The resolution of the previous approach was limited by the size of the electrode array — about 60 square pixels. Because the nanoparticle solution covers the whole retina, the new approach could potentially cover someone’s full field of vision. And because the nanoparticles respond to near-infrared light as opposed to visual light, the system doesn’t necessarily interfere with any residual vision a person may retain.

More work needs to be done before the approach can be tried in a clinical setting, Nie said, but this early research suggests that it’s possible.

“We showed that the nanoparticles can stay in the retina for months with no major toxicity,” Nie said of the research. “And we showed that they can successfully stimulate the visual system. That’s very encouraging for future applications.”

Reference:

Jiarui Nie, Kyungsik Eom, Hafithe M. AlGhosain, Intravitreally Injected Plasmonic Nanorods Activate Bipolar Cells with Patterned Near-Infrared Laser Projection, ACS Nano, DOI: 10.1021/acsnano.4c14061.

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Vaginal Birth Linked to Higher Risk of Midlife Urinary Incontinence: SWAN Cohort Study

Canada: A recent longitudinal analysis based on the Study of Women’s Health Across the Nation (SWAN) cohort has shed light on how childbirth experiences—particularly the number of children a woman has and the mode of delivery—can influence the risk of urinary incontinence (UI) during midlife.

The analysis showed that vaginal births significantly raised the risk of stress (OR 2.11) and mixed urinary incontinence (OR 1.89) in midlife compared to cesarean deliveries. Women with both vaginal and cesarean births had even higher odds of mixed incontinence (OR 2.17). In contrast, urge incontinence was more closely linked to aging than childbirth.

The findings were published online in Scientific Reports on 07 April 2025.

Parity has been shown to increase the risk of urinary incontinence, but the extent of this risk appears to vary based on the mode of delivery. To explore this relationship further, Nikki L Stephenson, Department of Obstetrics & Gynecology, University of Calgary, Calgary, AB, Canada, and colleagues examined how different delivery methods—vaginal versus cesarean—were associated with the prevalence of urge, stress, and mixed urinary incontinence during midlife.

For this purpose, the researchers examined the association between mode of delivery and subtypes of urinary incontinence using data from the SWAN cohort. They compared women who had undergone vaginal, cesarean, or a combination of both delivery types with those who had never given birth, aiming to understand how different childbirth experiences influence the risk of urge, stress, and mixed incontinence in midlife.

The key findings of the study were as follows:

  • Women who delivered vaginally had a significantly higher prevalence of all types of urinary incontinence compared to those who were nulliparous or delivered via other modes.
  • No significant differences in urinary incontinence were observed when comparing parous women (regardless of delivery type) with nulliparous women overall.
  • Compared to cesarean deliveries, vaginal births were associated with significantly higher odds of stress urinary incontinence in midlife.
  • Women who had both vaginal and cesarean deliveries faced significantly increased odds of developing mixed urinary incontinence compared to those who delivered exclusively via cesarean section.
  • Urge urinary incontinence was more strongly linked to aging rather than childbirth history.
  • Vaginal deliveries raised the risk of both stress and mixed urinary incontinence in midlife compared to cesarean births.
  • A combination of vaginal and cesarean deliveries further elevated the risk of mixed urinary incontinence during middle age.

“Parity and mode of delivery emerge as key factors influencing urinary incontinence in midlife. Parous women face a higher risk of stress and mixed incontinence, while the likelihood of urge incontinence appears lower compared to nulliparous women,” the authors noted. They further observed that “among multiparous women, vaginal delivery is associated with a greater risk of stress and mixed incontinence than cesarean birth.”

“These findings highlight the need for further research to validate the results across diverse populations and to better understand the underlying mechanisms driving these associations,” they concluded.

Reference:

Stephenson, N. L., Brenner, D., Brennand, E., Robert, M., Prisnie, K., & Metcalfe, A. (2025). Longitudinal analysis of the association between parity, mode of delivery and urinary incontinence in midlife using the SWAN cohort data. Scientific Reports, 15(1), 1-8. https://doi.org/10.1038/s41598-025-85603-0

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Young people with mental disorders less likely to become parents, reveals research

Using Finnish register data from over 1,2 million participants, the study found that both young men and women diagnosed with mental disorders are less likely to become parents compared to those without such diagnoses. The strongest associations were found for schizophrenia: persons diagnosed with this disorder were highly unlikely to have their first child by age 39 years.

Common mental disorders, such as depression and anxiety, also reduced the likelihood of parenthood. For example, men diagnosed with depression were 38% less likely to become fathers compared to those without depression diagnosis. Among women, depression was associated with 19% lower likelihood of becoming a mother when compared to persons without depression disorder diagnosis. The similar difference between men and women were also observed for anxiety disorder.

“The differences between men and women were clear for many disorders, with men having a lower likelihood of having a first child compared to women with the same disorder”, says Dr. Kateryna Golovina, university researcher and first author of the study.

The role of partnership status

The study also explored the role of partnership status in the link between mental disorders and parenthood. Since stable relationships are often a key factor in having children, difficulties in forming or maintaining partnerships may partially explain lower parenthood rates among people with mental disorders.

“We found a clear pattern: men with mental disorders were significantly less likely to cohabit than women with similar diagnoses”, says Associate Professor Christian Hakulinen, PI of the project.

The importance of accessible mental health services

The findings highlight the need for accessible, high-quality mental health services for young people. Providing long-term support may be particularly crucial in helping people with mental disorders navigate life decisions, including family formation.

“Our research underscores the importance of well-functioning mental health services with low-threshold access, ensuring young people receive the support they need for both their well-being and life aspirations,” says Kateryna Golovina.

Reference:

Kateryna Golovina, Ripsa Niemi, Mai Gutvilig, Markus Jokela, Marko Elovainio, Christian Hakulinen, Mental Disorders and Having a First Child Among Young Adults: A Nationwide Register-Based Cohort Study, BJOG An International Journal of Obstetrics & Gynaecology, https://doi.org/10.1111/1471-0528.18151.

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