NEUROLOGY

The SHAPES trial investigates adaptive electrical stimulation to reduce post-stroke elbow spasticity, potentially offering a cost-effective alternative to TENS or standard care.

Trial to Evaluate SHAPES for Post-Stroke Elbow Spasticity Reduction

The randomized controlled trial investigates the efficacy of Sheffield Adaptive Patterned Electrical Stimulation (SHAPES) compared to transcutaneous electrical stimulation (TENS) and standard care for reducing post-stroke elbow spasticity (PSES). A total of 297 participants with PSES will be allocated to one of three groups: SHAPES, TENS, or standard care (no electrical stimulation). SHAPES and TENS utilize a specialized electrical stimulation sleeve for daily use over six weeks. Efficacy is an 18% improvement in the 7-day Numerical Rating Scale (NRS-S) for PSES, evaluated at multiple time points up to 24 weeks post-treatment. Secondary outcomes include motor function and quality of life measures, with an economic evaluation conducted in parallel.

ENDO-DIABETOLOGY

Review finds mixed cost-effectiveness of personalized obesity interventions, highlighting gaps in advanced approaches.

Cost-Effectiveness of Personalized Obesity Interventions

A systematic review of 18 studies assessed the cost-effectiveness of personalized lifestyle interventions in adults with overweight or obesity. Seven cost-utility analyses found interventions cost-effective or dominant, while four found them not cost-effective. Evidence for behavioral personalization was mixed, and data on phenotype- and omics-based approaches remained limited, highlighting the need for further economic evaluations.

GYNAECOLOGY - IVF

Study identifies cervical screening barriers in Botswana, highlighting gaps in HPV knowledge and the need for targeted education.

Cervical Cancer Screening Barriers in Botswana

A cross-sectional study of 2,994 women in Botswana found that 67.2% had previously undergone cervical cancer screening, with higher uptake among women with HIV than those without HIV (80.0% vs 54.5%). Only 27.1% correctly identified high-risk human papillomavirus (hrHPV) as the cause. Key barriers included low prioritization, fear, lack of awareness, and service-related issues, highlighting the need for targeted education and HPV self-collection.

UROLOGY

Review examines decompression timing, drainage methods, and complications in infected obstructing urinary tract stones.

Emergency Decompression for Infected Urinary Tract Stones

Infection associated with obstructing upper urinary tract stones can progress to urosepsis and become life-threatening. A review examines key considerations in decompression and drainage before endoscopic lithotripsy, including predictive factors, indications, timing, choice of procedure, complications, and the optimal interval before definitive stone removal. The findings highlight the need for clearer evidence and consensus to guide treatment decisions.

FAERS analysis identifies potential drug-related ectopic pregnancy safety signals, warranting further clinical investigation.

Drug-Related Ectopic Pregnancy Safety Signals: FAERS Study

A pharmacovigilance study analyzing FDA adverse event reports from 2004 to 2024 identified 4,924 ectopic pregnancy reports. Levonorgestrel, etonogestrel, and clomifene showed the strongest disproportionate reporting signals, while 16 drugs emerged as potential novel safety signals. These findings may guide further drug-safety research but do not establish causation or confirm increased ectopic pregnancy risk.

Trial finds ex utero cord blood collection comparable to standard collection in weight, cellular composition, and contamination.

Ex Utero vs In Utero Umbilical Cord Blood Collection

A randomized clinical trial involving 101 umbilical cord blood collections found that ex utero collection, performed after placental delivery, was non-inferior to standard in utero collection in terms of blood unit weight. Cellular composition and bacterial contamination rates were also comparable, supporting ex utero collection as a clinically viable alternative that may improve maternal comfort during childbirth and facilitate cord blood donation.

Study links prior concussion to persistent choice reaction-time slowing in collegiate athletes, despite adjusted cognitive scores.

Concussion History and Reaction Time in Collegiate Athletes

A study of 547 NCAA Division I athletes found that those with a history of concussion had significantly slower choice reaction times than matched controls, even after adjusting for memory, concentration, and cognitive performance. No significant differences were observed in simple reaction time, Stroop reaction time, or shifting-attention reaction time, suggesting that choice reaction time may help detect subtle, persistent neurocognitive deficits after concussion.

Study highlights sexual health disparities among transgender individuals, emphasizing inclusive care and policies addressing stigma.

Sexual Health and Vulnerability Among Transgender Individuals

A cross-sectional study of 74 transgender individuals in São Paulo, Brazil, found differences in relationship status, sexual partnerships, and sex work between trans women and trans men. Trans women were more frequently single (76% vs 44.9%) and more likely to report sex work (21.7% vs 6.3%). The findings highlight the need for inclusive sexual health services and policies addressing stigma and structural inequalities.

Meta-analysis links tumor budding to poorer survival in endometrial cancer, highlighting the need for further validation.

Tumor Budding as a Prognostic Marker in Endometrial Cancer

A systematic review and meta-analysis of 10 studies involving 1,307 patients found that tumor budding was associated with poorer progression-free survival (HR 2.44) and overall survival (HR 1.89) in endometrial cancer. However, evidence linking tumor budding to lymph node metastasis was inconsistent. Standardized assessment and validation in larger, molecularly stratified studies are needed to establish its prognostic value.

Meta-analysis finds virtual reality reduces pain and anxiety during and after gynaecological procedures, with few minor adverse events.

Virtual Reality for Pain and Anxiety in Gynaecological Procedures

A systematic review and meta-analysis of 25 randomized controlled trials involving 2,438 women found that immersive virtual reality (IVR) significantly reduced pain and anxiety during and after gynaecological procedures. Post-procedural pain and anxiety showed greater reductions, while reported adverse events were minor and infrequent. IVR may offer a safe, non-pharmacological adjunct to improve patient comfort and procedural experience.

DENTISTRY

Topology-optimized titanium frameworks reduce dental prosthesis weight by up to 39.92%, with potential shock-absorbing benefits.

Topology-Optimized Titanium Frameworks for Dental Implants

A finite element analysis of 36 topology-optimized titanium frameworks for implant-supported full-arch dental prostheses found weight reductions exceeding 30%, with the Diamond lattice achieving 39.92 ± 2.60%. Despite greater flexibility and higher stress than solid frameworks, peak stress remained below titanium’s yield strength. Optimized designs also reduced reaction forces under canine and premolar loading, suggesting potential benefits for lightweight, shock-absorbing dental rehabilitation.

Review explores links between type 2 diabetes and gynecologic cancers, highlighting metabolic pathways and emerging treatment research

Type 2 Diabetes and Gynecologic Cancer: Mechanisms and Outcomes

A narrative review explores how type 2 diabetes and metabolic dysfunction may influence gynecologic cancers through insulin/IGF signaling, inflammatory pathways, and persistent immune and epigenetic changes. Evidence is particularly relevant to endometrial cancer, while findings in cervical and other HPV-related malignancies remain variable. The review highlights metformin research and emerging signals for other antidiabetic drugs, emphasizing the need for biomarker-driven studies and integrated metabolic assessment in cancer care.

Review finds laparoscopic nerve decompression may substantially relieve endometriosis-related sciatic pain, with an 8% major complication rate.

Laparoscopic Nerve Decompression for Endometriosis-Related Pain

A systematic review and meta-analysis of eight studies involving 744 individuals found that laparoscopic decompression of the sciatic nerve or sacral plexus was associated with substantial relief of endometriosis-related neuropathic pain. Across five studies involving 520 individuals, sciatic pain decreased by a pooled mean of 6.47 points on a 10-point scale. Major complications occurred in 8% of cases, highlighting the need for further high-quality research.

Review explores decidual cast expulsion, its potential causes and management, and the need to distinguish it from pregnancy loss.

Decidual Cast Expulsion: Symptoms, Causes and Management

A scoping review of 113 publications examined membranous dysmenorrhea and decidual cast expulsion, in which intact endometrial tissue passes through the vagina. Reported cases involved patients aged 9–53 years, with associations including hormonal treatments, infections, and ectopic pregnancy. Most cases resolved spontaneously, although some required uterine evacuation. The review highlights the importance of distinguishing this benign condition from early pregnancy loss.

Meta-analysis identifies bone and lung as the leading distant metastatic sites in cervical cancer, highlighting surveillance needs.

Cervical Cancer: Incidence and Sites of Distant Metastasis

A systematic review and meta-analysis of 42 studies involving 238,387 patients found a pooled incidence of non-lymphatic distant metastasis of 2.91 per 100 cervical cancer patients. Bone was the most commonly reported site (3.67 per 100), followed by lung (3.00), brain (1.83), and liver (1.70). Regional variation and substantial heterogeneity highlight the need for standardized studies to guide surveillance strategies.

Review of 89 studies links unconscious bias in obstetric care to reduced autonomy, unequal treatment, and maternal health inequities.

Unconscious Bias in Obstetric Care and Maternal Health Inequities

A systematic review of 89 studies found that unconscious bias in obstetric care can contribute to symptom dismissal, inadequate information sharing, unequal clinical decisions, and non-consented procedures. These practices disproportionately affect marginalized patients and may reinforce maternal health inequities, including disparities in pain management and severe maternal morbidity. The review calls for standardized protocols, improved communication, interpreter support, and institutional accountability.

New Trial to Assess SHAPE...

New Trial to Assess SHAPES Electrical Stimulation for Post-Stroke Spasticity