Category: 8. Health

Concurrent chemotherapy with radiation therapy did not significantly increase the cumulative incidence of second pelvic malignancies, though it did increase the cumulative incidence of second non-pelvic malignancies compared with chemotherapy alone in patients with locally advanced rectal cancer, according to results from a study shared in the International Journal of Radiation Oncology, Biology, Physics.

In the concurrent chemotherapy group, the 5- and 10-year cumulative incidences of second pelvic malignancy development was 2.1% (95% CI, 1.4%-3.0%) and 5.8% (95% CI, 4.2%-7.6%); in the chemotherapy alone group, the rates were 2.3% (95% CI, 0.92%-4.8%) and 4.2% (95% CI, 1.3%-9.8%), respectively. This difference did not reach statistical significance (Gray’s Test P = .3).

A multivariable analysis showed that older age was associated with second pelvic malignancies (MV HR, 3.03; 95% CI, 1.39-6.60; P = .005), though chemotherapy alone was not significantly associated with fewer second pelvic malignancies (MV HR, 0.66; 95% CI, 0.30-1.44; P = .3).

Intensity-modulated radiation therapy and volumetric modulated arc therapy techniques were associated with reduced risk of second pelvic malignancies vs conventional and 3D conformal radiation therapy on univariable analysis (P = .014).

The most common second pelvic malignancies were prostate adenocarcinoma (31%; n = 23) and uterine cancer (28%; n = 21); uterine cancers were mostly serous, clear cell, or endometrioid, though 5 patients in the concurrent chemotherapy group developed carcinosarcomas.

The 10-year cumulative incidence of non-pelvic second malignancies was 11.0% (95% CI, 9.1%-14.1%) in the concurrent chemotherapy group and 4.4% (95% CI, 2.2%-7.9%) in the chemotherapy alone group (Gray’s Test P = .017).

Univariable analysis showed that being older than 50 was significantly associated with increased risk of second non-pelvic malignancies (HR, 2.48; 95% CI, 1.40-4.11; P ≤.001), and being male was associated with a decreased risk (HR, 0.61; 95% CI, 0.44-0.85; P = .004). Further, diabetes was associated with a second non-pelvic cancer (HR, 1.51; 95% CI, 1.05-2.19; P = .028), and abstaining from tobacco decreased the risk of second non-pelvic cancer (HR, 0.63; 95% CI, 0.43-0.91; P = .013).

The most common second non-pelvic cancers were lung cancer (24%; n = 35), breast cancer (15%; n = 21), and hematologic malignancies (13%; n = 19). While 77% of those who developed a second non-pelvic cancer did not have a diagnosis of any other cancer, 13% did also develop a second pelvic malignancy.

Regarding radiation dosimetry and technique, 21 patients who developed a second pelvic malignancy had a chemotherapy plan available; of the 21, 9 developed uterine cancer with a mean dose of 4800cGy (range, 4296-5087).

The median overall survival (OS) in the concurrent chemotherapy group was 12 years (95% CI, 11-13) vs 24 years (95% CI, 15-unreached) in the chemotherapy alone cohort. The 5- and 10-year OS rates for those who received concurrent chemotherapy for rectal cancer was 78% (95% CI, 76%-80%) and 58% (95% CI, 55%-61%), respectively; in those who received chemotherapy alone, the rates were 88% (95% CI, 84%-91%) and 76% (95% CI, 70%-82%).

The 10-year survival for those who did not develop second pelvic malignancies was 60% (95% CI, 57%-63%) vs 77% (95% CI, 67%-87%) in those who did develop a second pelvic malignancy (P = .042).

“These data serve as a foundation for future prospective studies evaluating ways to further reduce the risk of second malignancies in high-risk patients undergoing [concurrent chemotherapy] for rectal cancer,” wrote lead study author Carla Hajj, MD, of the Department of Radiation Oncology at Memorial Sloan Kettering Cancer Center, and coauthors, in the paper. “Areas of potential investigation include personalized treatments using more modern technologies such as proton beam [radiation therapy] or MRI-based treatment deliveries, lifestyle changes, and robust survivorship programs.”

The study included 2624 patients with locally advanced rectal cancer, of whom 460 were treated with chemotherapy without radiation therapy and 2164 received concurrent chemotherapy. The most common adjuvant chemotherapy regimens were folinic acid, fluorouracil (5FU), and oxaliplatin (FOLFOX; 60%), 5FU (32%), and capecitabine/oxaliplatin (CapeOx; 4%).

Eligible patients had disease treated with chemotherapy with or without pelvic radiation therapy who were identified from an institutional database by Cancer Database, ICD-9/10, and ICD-0 histologic diagnosis codes for “rectum” or “rectosigmoid”.

Patients were ineligible for participation if they had received prior pelvic radiation therapy or if their treatment was for recurrent disease.

Second malignancies were defined as those preceding the rectal cancer diagnosis date by more than 6 months, synchronous cancers were defined as within 6 months of diagnosis, and metachronous cancers were defined as occurring between 6 months and 2 years after diagnosis. A second cancer was defined as occurring more than 2 years after diagnosis of locally advanced rectal cancer. The development of a non-pelvic cancer did not preclude capturing the diagnosis of a second pelvic cancer.

Reference

Tringale KR, Patel KH, Hilal L, et al. Development of second malignancies following chemotherapy with or without radiation therapy for the treatment of locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. Published online July 19, 2025. doi:10.1016/j.ijrobp.2025.07.1424

A long-term study suggests that cannabis-based medical treatments may bring lasting relief to people with chronic insomnia.

Over 18 months, patients reported not only better sleep but also reduced anxiety, less depression, and even lower pain levels. Side effects were mild and temporary for most, making cannabis a potential alternative where traditional sleep medications fall short.

Cannabis-Based Products Show Promise

People living with insomnia who used cannabis-based medical treatments reported sleeping better for as long as 18 months, according to research published August 27 in the open-access journal PLOS Mental Health. The study was led by Arushika Aggarwal of Imperial College London, U.K., along with her colleagues.

Sleep problems affect roughly one in three people, and about 10 percent of adults meet the criteria for an insomnia disorder. Standard treatment options are often hard to access, and medications approved for insomnia carry a risk of dependence.

To explore whether cannabis-based therapies might ease insomnia, the researchers reviewed outcomes from 124 patients who were prescribed medical cannabis. They tracked changes in reported sleep quality, anxiety and depression levels, and overall quality of life across one to 18 months of treatment.

Lasting Sleep and Mental Health Benefits

Patients consistently reported better sleep throughout the 18-month period. They also noted reduced anxiety and depression, along with lower levels of pain. Around nine percent experienced side effects such as fatigue, dry mouth, or insomnia, but none were considered serious. While more rigorous randomized controlled trials are required to confirm safety and effectiveness, the results suggest that cannabis-based medical products may provide a new avenue for improving sleep among people with chronic insomnia.

Co-author Dr. Simon Erridge, Research Director at Curaleaf Clinic, explained: “Over an 18-month period, our study showed that treatment for insomnia with cannabis-based medicinal products was associated with sustained improvements in subjective sleep quality and anxiety symptoms. These findings support the potential role of medical cannabis as a medical option where conventional treatments have proven ineffective, though further randomised trials are needed to confirm long-term efficacy.”

Importance of Long-Term Monitoring

He adds: “Conducting this long-term study provided valuable real-world evidence on patient outcomes that go beyond what we typically see in short-term trials. It was particularly interesting to observe signs of potential tolerance over time, which highlights the importance of continued monitoring and individualised treatment plans.”

Reference: “UK Medical Cannabis Registry: A clinical outcomes analysis for insomnia” by Arushika Aggarwal, Simon Erridge, Isaac Cowley, Lilia Evans, Madhur Varadpande, Evonne Clarke, Katy McLachlan, Ross Coomber, James J. Rucker, Mark W. Weatherall and Mikael H. Sodergren, 27 August 2025, PLOS Mental Health.
DOI: 10.1371/journal.pmen.0000390

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Doctors often struggle to get clear images of the inner ear, a tightly protected organ encased in bone. The body’s natural obstacles make it difficult to get magnetic resonance imaging (MRI) contrasts into the ear to diagnose tumors, infections, or malformations. Now a team of researchers has developed a nanoparticle-based MRI contrast that can grab on to inner ear cells and sneak its way inside (Chem. Biomed. Imaging 2025, DOI: 10.1021/cbmi.5c00049).

“Standard . . . imaging agents rarely reach this tissue and clear out very fast, forcing clinicians to use higher doses, which raises the risk of hearing damage and toxicity,” says Huan Wang, a biomedical chemist at Changchun Institute of Applied Chemistry and the study’s senior author. The challenge comes from a protective set of cells lining the blood vessels between the middle and inner labyrinth of the ear—the blood-labyrinth barrier, or BLB.

This cellular defense allows nutrients and oxygen to pass through but blocks other molecules, including many drugs and contrast agents. To address this, Wang’s team has created the first guided MRI nanoprobe shown to cross this BLB and accumulate in the inner ear.

The probe combines three features: an iron oxide core just 3.3 nm across that serves as the MRI contrast, a polyethylene glycol (PEG) coating that keeps the contrast circulating in the bloodstream, and a short peptide intermingled with the PEG called IETP2.

Wang explains that the IETP2 sticks to LRP1—a receptor found throughout the body but especially abundant in the BLB—which is able to ferry useful molecules across the barrier, essentially letting the nanoprobe hitch a ride into the inner ear. “By attaching the nanoparticles to a peptide which targets the receptor on the BLB, the team found a way to push the probes past the barrier,” says Carmen Burtea, a biomedical imaging researcher at Université de Mons who was not involved in the study.

In mice, the nanoprobes crossed the BLB efficiently and stayed in circulation long enough to reach the cochlea. They produced up to 84% stronger MRI signals than untargeted controls, with no damage to any major organs.

“The untargeted version of the nanoprobe is already known to enhance contrast at lower doses than [standard] gadolinium agents,” Burtea says. She adds that if the probe passes risk assessments, it could give doctors a new tool to diagnose both fluid buildup and structural changes within the inner ear.

Wang agrees that clinical translation will require toxicology tests and larger-animal studies. Johannes Gerb, a biomedical imaging researcher at Ludwig Maximilian University Munich who also was not involved in the study, notes that if the probe can match gadolinium’s performance at lower cost and with comparable safety in humans, “it could become a viable alternative.”

Looking ahead, Wang says that “the platform can also be used as a general platform to ferry drugs or gene therapies to the inner ear,” though he cautions that avoiding unintended delivery to other LRP1-expressing tissues would require troubleshooting. The potential also resonates with clinicians. “Modalities such as this are an exciting avenue as they can definitely reduce the toxic loads of current medications,” says Rajesh Bhardwaj, an otolaryngologist at MedFirst ENT Centre in India who was not involved in the study.

Many of us are guilty of scrolling our smartphones on the toilet. But a new study from the United States, published today, has found this habit may increase your risk of developing haemorrhoids by up to 46%.

So, what’s the link? How can time on your phone lead to these painful lumps in and around your anus? Here’s what we know.

What are haemorrhoids?

Every healthy person has haemorrhoids, sometimes called piles. They are columns of cushioned tissue and blood vessels found close to the opening of the anus.

Haemorrhoids have a really important role in maintaining bowel continence or, to put it simply, keeping your poo in.

When all is well, we don’t notice them. But haemorrhoids can get swollen and this can lead to symptoms such as pain, bleeding or feeling a lump just inside your anus (internal haemorrhoids) or protruding outside (external haemorrhoids).

So when someone “has haemorrhoids”, it means they have become inflamed or symptomatic.

This is extremely common: more than one in two of us will experience symptomatic haemorrhoids at some point in our lives.

You are more likely to get haemorrhoids if you:

• are older (over 45)
• are pregnant
• are overweight
• have persistent constipation or diarrhoea
• regularly lift heavy objects
• spend a lot of time on the toilet.

The link between toilet time and haemorrhoids

Prolonged sitting in general has not been linked to developing haemorrhoids.

However, a standard toilet seat – unlike a chair or couch – has a large internal opening that provides no support for the pelvic floor (the group of muscles and ligaments that support the bladder, bowel and uterus).

Prolonged sitting on a toilet seat is believed to increase pressure inside the pelvic floor and lead to blood pooling in the vascular cushions of the anus. This makes haemorrhoids more likely to develop.

What the new study looked at

The new US study recruited 125 adults, aged 45 and older, who were undergoing a colonoscopy at Beth Israel Deaconess Medical centre.

Researchers surveyed them about their smartphone habits while using the toilet, including how often they checked their phone and for how long. Participants also reported on other behaviours such as straining, their fibre intake, and how much physical activity they did.

The researchers recorded whether they had haemorrhoids. Since the participants were all having a colonoscopy, the presence of internal haemorrhoids could be directly confirmed visually.

What did the study show?

Two-thirds (66%) of all participants used smartphones while on the toilet. The most common activity was reading news (54.3%), followed by social media (44.4%).

Those who used their smartphones spent longer on the toilet than those who didn’t. More than one in three (37.3%) toilet smartphone users spent over five minutes on the toilet, compared to just over one in 20 (7%) of those who didn’t use their smartphones.

The smartphone users had a 46% higher risk of haemorrhoids, compared to those who didn’t use their smartphone. To calculate this, researchers took into account other known risk factors for haemorrhoids such as gender, age, body mass index, exercise activity, straining and fibre intake.

However, unlike some other research, this study did not find a link between straining and haemorrhoids.

As a result, the researchers concluded that time spent on the toilet poses a more significant risk for haemorrhoids than straining. However, we can’t rule out straining as a risk factor, based on one study.

Some other limitations to consider

The study relied on participants remembering whether or not they strained, and how long they spent on the toilet.

This kind of recall is subjective, and may also be influenced by taking part in the study. For example, if the participants thought they had haemorrhoids, they may be more likely to report straining.

The study’s small sample size and the participants’ age (all over 45) also mean it is unlikely to be representative of the broader population.

Toilet sitting time

The new study is not the first to study the link between time spent on the toilet and developing haemorrhoids. In 2020, a Turkish study found spending more than five minutes on the toilet was associated with haemorrhoids.

Another 2020 study from Italy of 52 people with diagnosed internal or external haemorrhoids noted the longer they spent on the toilet, the more severe their haemorrhoids.

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Read more:
Do men really take longer to poo?

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So, what are we doing on the toilet?

Defaecation itself usually doesn’t take long. One study found it took healthy adults an average two minutes when sitting, but only 51 seconds when squatting.

The majority of “toilet sitting time” usually means just that – sitting on the toilet, doing other activities aside from pooing (or weeing).

One 2008 study from Israel surveyed 500 adults and found more than half (52.7%) read books or newspapers while on the toilet. It also found toilet readers spent significantly more time on the toilet.

How to avoid haemorrhoids

The usual advice is to increase the amount of fibre in your diet (eating more fruit, vegetables and wholegrains) and ensure you drink enough water. This makes it easier to pass a stool and reduces straining – which you should also try to avoid.

However, the new research confirms previous evidence that cutting down toilet sitting time may also help. So, avoiding distractions by leaving your smartphone outside the bathroom is a good idea (and as a bonus, will expose your device to fewer germs).

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Read more:
Your phone is covered in germs: a tech expert explains how to clean it without doing damage

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If you have any concerning symptoms, such as blood in your stool, a new lump in the anal region, or pain when passing a bowel motion then you should see your local doctor for further investigations and treatment.

Sweeteners found in yoghurts and fizzy drinks can damage people’s ability to think and remember, and appear to cause “long-term harm” to health, research has found.

People who consumed the largest amount of sweeteners such as aspartame and saccharin saw a 62% faster decline in their cognitive powers – the equivalent to their having aged 1.6 years, researchers say.

They concluded: “Our findings suggest the possibility of long-term harm from low- and no-calorie sweeteners (LNCs) consumption, particularly artificial LNCs and sugar alcohols, on cognitive function.”

The findings are the latest to warn about the dangers posed by sweeteners. Previous studies have suggested they may increase the risk of a range of diseases including type 2 diabetes, cancer, heart problems, depression and dementia, and damage the gut wall.

Sweeteners’ association with cognitive decline is of such concern that consumers should instead use either tagatose, a natural sweetener, or alternatives such as honey or maple syrup, the researchers said.

They looked at the impact of seven sweeteners on the health of the study’s participants – 12,772 civil servants in Brazil, with an average age of 52 – who were followed up for on average eight years. Participants completed questionnaires detailing their food and drink intake over the previous year, and later underwent tests of their cognitive skills such as verbal fluency and word recall.

People who consumed the most sweeteners experienced declines in their thinking and memory skills 62% faster than those with the lowest intake, the researchers found. This was “the equivalent of about 1.6 years of ageing”, the researchers said.

Consumption of combined and individual LNCs, particularly aspartame, saccharin, acesulfame K, erythritol, sorbitol and xylitol, was associated with cognitive loss.

“Daily consumption of LNCs was associated with accelerated decline in memory, verbal fluency and global cognition,” the authors say in their paper, published in the American medical journal Neurology.

However, the trend was only observed in participants under the age of 60. That shows that middle-aged adults need to be encouraged to use fewer sweeteners, they added.

The sweeteners studied are also found in flavoured water, low-calorie desserts and energy drinks.

“Low and no-calorie sweeteners are often seen as a healthy alternative to sugar. However, our findings suggest certain sweeteners may have negative effects on brain health over time,” said Claudia Kimie Suemoto, of the University of São Paulo in Brazil, the study’s lead author.

Food and drink industry bodies cast doubt on the findings. “By the authors’ own admission, this study cannot prove cause,” said Gavin Partington, the director general of the British Soft Drinks Association.

“Non-sugar sweeteners are safe, according to all leading health authorities in the world, and that’s why they have been used in a vast array of food, medicine, dental and drinks products for many decades.

“Their use in soft drinks has helped UK manufacturers to remove just under three-quarters of a billion kilograms of sugar from product since 2015.”

The International Sweeteners Association (ISA) said there was an “established scientific consensus” that sweeteners are safe.

“This research is an observational study, which can only show a statistical association, not a direct cause-and-effect relationship,” the ISA said in a statement. “The reported link between sweetener consumption and cognitive decline does not prove that one causes the other.”

Artificial sweeteners may carry unexpected risks for brain health, a new study claims.

A study published in Neurology examined the diets of more than 12,700 adults in Brazil, and found that those who consumed the highest amounts of low- or no-calorie sweeteners experienced faster declines in memory and thinking skills over an eight-year period.

The effect was particularly pronounced among people with diabetes and those under 60. 

The researchers assessed seven sweeteners commonly found in diet sodas, flavoured waters, yoghurts and low-calorie desserts: aspartame, saccharin, acesulfame-K, erythritol, xylitol, sorbitol and tagatose.

Of these, all except tagatose were linked to cognitive decline, especially in memory and verbal fluency.

Participants were divided into three groups based on their intake. Those consuming the most – around 191 milligrams a day, the equivalent of a single can of diet soda for aspartame – showed cognitive decline 62 per cent faster than those consuming the least, roughly equal to an extra 1.6 years of ageing.

“Low- and no-calorie sweeteners are often seen as a healthy alternative to sugar, however, our findings suggest certain sweeteners may have negative effects on brain health over time,” said study author Prof Claudia Kimie Suemoto of the University of São Paulo.

“Previous research had linked artificial sweeteners to conditions like diabetes, cancer, cardiovascular disease and depression, but their potential impact on cognition had not been investigated.”

One of the more surprising results was that the link appeared only in adults younger than 60. 

“I had expected the association to be more evident in older adults, since they are at higher risk of dementia and cognitive impairment,” Suemoto said. “Instead, our results suggest that midlife exposure to sweeteners may be particularly harmful, which is important because midlife is a critical period for setting the trajectory of brain health.”

The findings do not prove that sweeteners directly cause cognitive decline. Factors such as self-reported diet and the absence of all types of sweeteners in the study are limitations. 

Still, Suemoto said the results warrant caution and further research, including brain imaging and mechanistic studies of gut health and inflammation.

Her team is already working on neuroimaging studies to understand what could be causing the link, the results of which are not yet available. 

“More research is needed to confirm our findings and to investigate if other refined sugar alternatives, such as applesauce, honey, maple syrup or coconut sugar, may be effective alternatives,” Suemoto said.

About our expert

Claudia Suemoto is an assistant professor at the University of São Paulo, Brazil. She’s also a trained physician whose research has been published in journals such as The Lancet, Nature Neuroscience and The Journal of Alzheimer’s Disease.

Read more:

Sept. 2 (UPI) — People who consume the highest levels of artificial sweeteners during middle age show the fastest declines in cognitive functions, such as memory, as they move into their senior years, according to a study released Wednesday.

The study of nearly 13,000 middle-aged Brazilian adults who were followed for an average of eight years revealed that those who consumed the most aspartame, saccharin and five other kinds of sweeteners experienced cognitive declines at a 62% faster clip than those who consumed the lowest amounts, the researchers said.

That difference equates to about 1.6 years of aging, according to the study published in the journal Neurology.

The link between sweeteners and the rapidity of decline was even stronger in people with diabetes, particularly for memory loss.

However, there appeared to be no effect in participants aged 60 and older. This suggests exposure to artificial sweeteners during midlife — when many people turn to them to lose weight — may carry lifelong consequences for brain health, according to the researchers from the University of Sao Paulo and elsewhere in Brazil.

The seven artificial sweeteners studied were aspartame, saccharin, acesulfame k, erythritol, sorbitol, xylitol and tagatose. Daily consumption of any or all them in midlife was associated with accelerated decline in memory, verbal fluency and global cognition in later years, the researchers reported.

The study, supported by the Brazilian Ministry of Health, had some limitations, including that the diet information used was reported by the participants themselves, and they may not have remembered accurately everything they ate.

It builds on earlier work by the Brazilian researchers connecting ultra-processed foods with faster cognitive decline. Many such foods marketed as sugar-free contain artificial sweeteners, noted co-author Claudia Kimie Suemoto, an associate professor of geriatrics at the University of Sao Paulo.

“By following more than 12,000 adults for eight years, our study adds robust evidence that these compounds may not be harmless, particularly when consumed frequently and starting in midlife,” she told UPI in emailed comments.

“In the broader scientific context, our findings highlight the need to look more critically at what we are using to replace sugar in our diets, and they underscore that dietary choices in midlife can have consequences for brain health decades later.”

Suemoto said her study is the largest and longest prospective study to date investigating the association between artificial sweetener consumption and cognitive decline, adding that the few studies published on the topic previously had smaller samples and followed participants for shorter periods of time.

“Moreover, while previous research had linked sweeteners to conditions such as diabetes, cardiovascular disease and depression, their long-term impact on cognition had not been systematically explored,” she added.

One of the most surprising findings, she said, was that the association between low- and no-calorie sweetener consumption and cognitive decline was only significant among participants younger than 60.

“I had expected the association to be more evident in older adults, since they are at higher risk of dementia and cognitive impairment,” Suemoto said. “Instead, our results suggest that midlife exposure to sweeteners may be particularly harmful, which is important because midlife is a critical period for setting the trajectory of brain health.

“Cognitive decline and dementia are thought to begin developing decades before symptoms become noticeable, so exposures during midlife may accelerate these processes and have long-term consequences.”

The key takeaway is a new understanding of the importance of getting a handle on dietary habits earlier in adulthood, “when preventive strategies could have the greatest impact,” she said.

The Brazilian findings intertwine with what already was suspected about the negative effects of low-calorie sweeteners on brain health, said Pradeep Bhide, the Jim and Betty Ann Rodgers Eminent Scholar Chair of Developmental Neuroscience at Florida State University and director of FSU’s Institute for Pediatric Rare Diseases.

He told UPI the results “echo” his findings from a 2022 study on aspartame, in which he found that daily consumption in mice can lead to behavioral and cognitive impairments, such as anxiety-like behavior, learning deficits and memory impairment, likely due to the sweetener’s effects on the brain’s neurotransmitter systems.

“Importantly, our own experimental studies also demonstrated that these effects were not limited to the exposed individuals, but were transmitted from aspartame-exposed fathers to their offspring across two generations,” he said.

Despite the Brazilian study’s limitations, its combination of large-scale human data and controlled laboratory findings “strengthens the concern that chronic exposure to artificial sweeteners may have significant neurobehavioral consequences,” Bhide said.

“These results underscore the need for caution in the widespread use of such sweeteners and highlight the importance of further mechanistic studies.”

Theresa Gentile, a registered dietitian nutritionist and spokeswoman for the Academy of Nutrition and Dietetics, said the study highlights a possible “worsening” of risk for those with diabetes and cerebrovascular disease.

“Many people choose sugar-free or ‘diet’ products thinking they’re the healthier option, but this research suggests that they might not be the best choice for brain health,” she told UPI. “Overall, the study highlights that being careful with sweetener choices could help protect both blood vessel health and memory.”

The study reinforces earlier evidence linking sweeteners to health risks like and “adds weight by showing that many of the same sweeteners may also harm brain health over the long term,” she said.

It also “supports the gut-brain connection, since changes in gut bacteria and inflammation are possible ways these sweeteners could affect memory and thinking.”

Meanwhile, the study demonstrated that not every sweetener is the same regarding cognition. Tagatose, sold as a lower-calorie alternative to sucrose, “stood out as not being linked to cognitive decline, which suggests some natural sweeteners may be better options for cognition than others,” Gentile added.

Alongside preventing pregnancy, hormonal contraceptives (HCs) may be effective for managing endometriosis, polycystic ovary syndrome, and irregular cycles, according to a recent study published in Hormones and Behavior.¹

These contraceptive methods have also been linked to mood changes, weight fluctuations, and emotional ups and downs. Overall, stronger emotional responses were found in women using HC vs those without contraception, which may help this population move past negative emotional experiences.¹

“For women, the findings highlight what many have long suspected: Birth control can affect more than reproductive health,” said Beatriz Brandao, lead study author and graduate student at Rice University. “Hormonal birth control does more than prevent pregnancy—it also influences brain areas involved in emotions and memory.”¹

Experimental conditions and contraceptive use

There were 179 participants aged 18 to 35 years included in the analysis, 87 of whom were in the HC group and 92 were in the natural cycle (NC) group.² Eligibility criteria for the HC group included at least 3 months of active HC use before study participation, while the NC group included patients with no HC use for at least 3 months before participation.

Patients with current pregnancy, pregnancy within the past year, hysterectomy or menopause history, and breastfeeding were excluded from the analysis. Participants were randomized to 1 of 3 experimental conditions.²

These included no emotional regulation for controls, distancing towards negative images and Immersion towards positive images (D/I), and Reinterpretation towards negative images and Immersion towards positive images (R/I). HC and NC participants were balanced across these conditions.²

Emotional regulation techniques

Reproductive status, demographics, and medical history data was obtained using a demographics form and a Medical Screening Form. Questionnaires were also distributed to determine emotion regulation abilities, tendencies, and mental health.²

A reproductive health questionnaire was distributed to evaluate participants’ HC use, reproductive health history, menstrual cycle characteristics, and medication use. Current HC use was reported by 49% of participants, with 86.2% indicating they used HCs for reproductive purposes and 13.8% reporting use for non-contraceptive reasons.²

Distancing from negative images was defined as developing an impartial viewpoint of negative stimulus, while reinterpretation was defined as changing the meaning of an image by stating something to feel less negative. Immersion in positive images was defined as approaching them with an engaged mindset, picturing them close to oneself.²

Emotional reactivity and HC use

Demographic and questionnaire results did not significantly differ between HC users vs nonusers. When assessing emotional reactivity, investigators found a significant main effect of HC status. Emotional reactivity was significantly greater among participants using HCs vs those not using HCs (F(1,173) = 5.30, p = .022).²

Increased emotional reactivity was also observed for negative relative to positive images (F(1,173) = 52.19, p < .001). Emotion significantly correlated with the experimental group, with a greater difference reported in those utilizing R/I vs D/I. The control group presented with the greatest difference in emotional reactivity.²

Investigators also highlighted a significant main effect of emotion in the D/I group (F(1, 57) = 12.28, p < .001). These patients had increased emotion regulation success toward positive images vs negative images, and this effect was also observed in HC users vs nonusers.²

Applying immersion toward positive images was linked to increased emotion regulation success vs either reinterpretation or distancing toward negative images. HC status did not significantly impact this correlation.²

Implications for women’s health

These results indicated an impact of HC on emotional activity and emotional regulation success. Investigators concluded that psychological and cognitive components are both effective for use in women’s health care.²

“These results are novel and shed light on how hormonal contraceptives may influence emotion and memory processes in important ways,” said Bryan Denny, PhD, BA, MA, study co-author and associate professor of psychological sciences at Rice University.¹

References

1. Millions of women rely on contraceptives, but new Rice study shows they may do more than just prevent pregnancy. Rice University. August 29, 2025. Accessed September 3, 2025. https://www.eurekalert.org/news-releases/1096501.
2. Brandao BM, Castro M, Buergler JB, Clark KR, Denny BT, Leal SL. Emotion regulation strategies differentially impact memory in hormonal contraceptive users. Hormones and Behaviors. 2025;175. doi:10.1016/j.yhbeh.2025.105805

Sep 3 2025

Noninferiority was not demonstrated for death and ischemic events between P2Y12 inhibitor monotherapy and dual antiplatelet therapy (DAPT) given for 12 months after stenting in patients with acute coronary syndromes (ACS), according to late-breaking research presented in a Hot Line session today at ESC Congress 2025 and simultaneously published in New England Journal of Medicine.

DAPT consisting of aspirin plus a potent P2Y12 inhibitor for 12 months is recommended for patients with ACS (myocardial infarction [MI] and unstable angina) after percutaneous coronary intervention (PCI) with stent implantation.

Recent evidence suggests that withdrawal of aspirin after 1 to 3 months of DAPT, followed by P2Y12 inhibitor monotherapy may reduce bleeding while preventing recurrent ischemic events compared with 12 months of DAPT. We conducted the NEO-MINDSET trial to specifically investigate if P2Y12 inhibitor monotherapy could be used in the early phase, immediately after PCI and for the entire 12 months compared with DAPT for 12 months.”

Pedro Lemos, Principal Investigator, Professor from the Hospital Israelita Albert Einstein, Sao Paulo, Brazil

The open-label randomized controlled NEO-MINDSET trial was conducted across 50 sites in Brazil. Patients with ACS undergoing successful PCI with drug-eluting stents were randomized 1:1 within the first 4 days of hospitalisation to stop aspirin and receive potent P2Y12 inhibitor monotherapy (ticagrelor or prasugrel) or to DAPT (aspirin plus a potent P2Y12 inhibitor) for 12 months.

The first primary outcome was a composite of death, MI, stroke or urgent target-vessel coronary revascularisation, with an absolute risk difference of 2.5 percentage points set as the prespecified noninferiority margin. The second primary outcome was major or clinically relevant nonmajor bleeding, with superiority testing if the first primary outcome was noninferior.

The analysis population included 3,410 randomized patients who had a mean age of 59.6 years, with 29.3% being women.

The ischemic primary endpoint occurred in 7.0% of patients in the monotherapy group and 5.5% in the DAPT group (hazard ratio [HR] 1.28; 95% confidence interval [CI] 0.98 to 1.68), resulting in an absolute risk difference of +1.47 percentage points (95% CI −0.16 to 3.10), which did not meet the prespecified criteria for noninferiority (p=0.11).

Major or clinically relevant nonmajor bleeding occurred in 2.0% of patients in the monotherapy group and 4.9% in the DAPT group (risk difference −2.97 percentage points; 95% CI −4.20 to −1.73).

The incidence of all-cause death was 3.6% in the monotherapy group and 3.0% in the DAPT group (HR 1.24; 95% CI 0.85 to 1.79). Any bleeding occurred in 4.5% of patients in the monotherapy group and 9.0% in the DAPT group.

A landmark analysis on the ischemic primary endpoint revealed a risk difference of +1.5 percentage points during the first 30 days and 0.0 percentage points from 30 days to 12 months for P2Y12 inhibitor monotherapy vs. DAPT. For the bleeding primary endpoint, the risk difference was −0.8 percentage points during the first 30 days and −2.2 percentage points from 30 days to 12 months for monotherapy vs. DAPT.

Summarizing the findings, Professor Lemos concluded: “We failed to demonstrate the noninferiority of aspirin-free monotherapy initiated immediately after PCI with regard to the ischemic primary endpoint over 12 months. Results from the landmark analysis suggest that the excess ischemic risk with monotherapy occurred in the first 30 days, with comparable outcomes thereafter. Bleeding appeared to be lower at both 30 days and 12 months with monotherapy vs. DAPT.”