Category: Statistics

Cancer Biother Radiopharm. 2026 Apr 13:10849785261431195. doi: 10.1177/10849785261431195. Online ahead of print.

ABSTRACT

Background: Pancreatic ductal adenocarcinoma (PDAC) has one of the poorest treatment responses since it contains desmoplastic stroma, lacks good vascularity, and has high interstitial fluid pressures, which are the most damaging factors depriving chemotherapy. Liposomal doxorubicin is much better in terms of systemic pharmacokinetics but is not efficient in PDAC due to the significant barrier of nanoparticles-stromal and vascular barriers.Purpose/Hypothesis: In a bid to eliminate these shortcomings, this paper presents CavitoMod-UTMDNet, which is an integrated mechanistic and experimental platform capable of utilizing ultrasound-targeted masterpiece unaffiliating (UTMD) as a means of temporarily improving vascular and stromal permeability and better intratumoral delivery of liposomal doxorubicin.Population/Subjects: The model combines Rayleigh-Plesset cavitation modeling and Fickian diffusion analysis with a two-compartment pharmacokinetic model and systematic in vitro and in vivo validation.Assessment: Passive cavitation detection was used to establish stable cavitation exposure windows within FDA-acceptable mechanical index limits.Statistical Tests: UTMD increased intracellular drug uptake 3.2-3.8fold and reduced IC 0 in PANC-1 and BxPC-3 pancreatic cancer cell lines by around 50% in the presence of a stable cavitation (MI 1.2). UTMD progressively improved the level of intratumor drug delivery in the orthotopic immunodeficient mouse models (NU/NU strain) (2.4-fold) and led to a 54% decrease in tumor volume 21 days later without any trace of hepatic, renal, and cardiac toxicity.Results: There were strong links between cavitation energy density and drug uptake and diffusion depth and therapeutic response as evidence that there is a mechanistic character to UTMD-enhanced actions. It will support the drug development in a better way. CavitoMod-UTMDNet is a combined strategy to maximize ultrasound-enhanced nanocarrier (nanoparticles) delivery using a physics-based reproducible plan to optimize ultrasound-enhanced nanocarrier delivery in PDAC that will see improvement in future translation to image-guided therapeutic strategies.

PMID:41969145 | DOI:10.1177/10849785261431195

Pediatr Pulmonol. 2026 Apr;61(4):e71600. doi: 10.1002/ppul.71600.

ABSTRACT

BACKGROUND: Although survival for childhood acute lymphoblastic leukaemia (ALL) has improved, long-term pulmonary function deficit remains a concern. We aimed to explore the prevalence of pulmonary function deficit and abnormal pulmonary function tests in childhood ALL survivors and clinical associations.

METHODS: This national, retrospective cohort study (February 2019-May 2024) included eligible 5-17.9 year-old survivors (N = 295) who performed a valid pulmonary function test ≥ 1 year after treatment (N = 185). Clinical associations included treatment characteristics, pulmonary diagnosis, and radiological findings from medical charts.

RESULTS: Among 185 survivors, 37% (95% confidence interval (CI): [30, 45]) had pulmonary function deficit, with the highest prevalence (56%) among 15-17.9-year-olds. Abnormal test prevalence was 37% [27, 48] for diffusing capacity (carbon monoxide and/or nitric oxide), 29% [22, 38] for lung clearance index, 12% [8,18] for forced expiratory volume in the first second, and 11% [7, 17] for broncho-dilator response. Bronchiolitis obliterans, stem cell transplantation and CT-verified bronchiectasis were significant clinical associations of pulmonary function deficit (100%, 97.5% CI: [40, 100], 89% [76, 103], 73% [51, 96]) and abnormal diffusing capacity (100% (97.5% CI [29, 100]), 82% [59, 105], 75% [45, 105]), respectively. Bronchiectasis (88% [65, 110]) and transplantation (64% [39, 89]) were associated with a higher prevalence of abnormal lung clearance index. Bronchiolitis obliterans (75% [19, 99]) and transplantation (61% [39, 84]) were associated with a higher prevalence of abnormal forced expiratory volume in the first second.

CONCLUSIONS: Pulmonary function deficit was frequent in childhood ALL survivors, especially after stem cell transplantation or pulmonary disease. Tailored long-term pulmonary monitoring, including small airway function and diffusing capacity, may aid in timely detection and intervention.

PMID:41969139 | DOI:10.1002/ppul.71600

ScientificWorldJournal. 2026;2026(1):e6175776. doi: 10.1155/tswj/6175776.

ABSTRACT

The emerging issue of carbon dioxide (CO₂) emissions is highly affecting global sustainable and economic development endeavors. Countries with high population growth, rapid industrialization, and significant energy needs find themselves in this bracket. This study, based on data from 1960 to 2018, evaluates carbon emissions using principal component analysis (PCA). The findings indicate that two leading principal components (C.1 and C.2) had the greatest impact as they accounted for seventy-seven percent (77%) of the total variance. The eigenvalues of both components were greater than one, signifying their significance. C.1 shows a strong connection for CO₂ emissions, total population, and production of electric energy through various sources. C.2 is more connected to the growth of industries. The scree plot confirms this by finding them to be dominant. This emphasizes the interaction between electricity production, specifically from coal, and the demographic data. The results highlight how PCA can be utilized to distinguish drivers that cause the emission of carbon to provide an understanding that might be used in managing the environment and setting relevant policies.

PMID:41969135 | DOI:10.1155/tswj/6175776

J Pediatr Endocrinol Metab. 2026 Apr 14. doi: 10.1515/jpem-2025-0685. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of androgens on retinal microvasculature in prepubertal girls with isolated premature pubarche (PP) with optical coherence tomography (OCT) and OCT angiography (OCTA).

METHODS: Eighty-six prepubertal, non-obese girls with isolated PP with normal birth weight and 86 age-matched control girls were evaluated. Retinal microvascular structures in the macular and optic disc regions were examined using OCT and OCTA. Data from subjects with isolated PP were compared with data from healthy controls. Correlations between dehydroepiandrosterone sulfate (DHEA-S), androstenedione (AS), testosterone, 17-hydroxyprogesterone (17-OHP) levels, bone age, pubertal stage as well as OCT and OCTA parameters were evaluated.

RESULTS: The inferior retinal nerve fiber layer (RNFL) thickness in the isolated PP group was significantly higher than the control group (p=0.007). A statistically significant increase in the vessel density (VD) was observed in temporal quadrant of the superficial capillary plexus (SCP) and inferior quadrant of the deep capillary plexus (DCP) in the isolated PP group compared with the control group (p<0.05). There were significant positive correlations between DHEAS, AS, testosterone levels and RNFL, macula-disk regions’s OCTA parameters (p<0.05).

CONCLUSIONS: In the isolated PP patients, thickening of RNFL and increased VD in the macula and optic disc region were recognized under the effect of androgens compared to the control group. In these patients, early microvascular changes can be detected noninvasively by means of OCT and OCTA. These findings suggest a potential link between androgen exposure and retinal microvascular alterations; however, further studies are needed to explore their clinical implications.

PMID:41969133 | DOI:10.1515/jpem-2025-0685

J Acquir Immune Defic Syndr. 2026 May 1;101(5):547-554. doi: 10.1097/QAI.0000000000003809.

ABSTRACT

INTRODUCTION: Steatotic liver disease (SLD) and liver fibrosis are significant comorbidities in people living with HIV (PLHIV). Early detection is essential for effective management. This study evaluated the utility of the Fatty Liver Index (FLI) in detecting hepatic steatosis (HS) using Controlled Attenuation Parameter (CAP) measurements as the reference.

METHODS: This cross-sectional study included 446 PLHIV recruited from Cairo University Hospitals. HS was defined as CAP values exceeding 248 dB/m. FLI cut-off points were determined using the Youden index with bootstrapping validation. Performance metrics and kappa concordance statistics were calculated.

RESULTS: The study cohort (78.7% male, median age 35) showed HS in 27.1% (n = 121) and significant liver fibrosis in 6.5% (n = 29). Optimal FLI cut-off of 45 yielded 71% sensitivity and 72% specificity (receiver operating characteristic = 0.77), while the 60 cut-off provided 57% sensitivity and 80% specificity. Despite similar overall prevalence estimates between methods (30.3% by FLI vs. 27.1% by CAP), significant discordance existed (P < 0.001) with only low-moderate agreement (73.5% agreement, κ = 0.465). Nearly half (49%) of participants with CAP-defined HS were misclassified as having no SLD when using FLI. Importantly, HS was associated with significant liver fibrosis when identified by CAP (P < 0.05) but not when identified by FLI (κ = 0.078, P > 0.05).

CONCLUSION: FLI demonstrates substantial limitations as a screening tool for HS in people living with HIV, missing nearly half of CAP-defined cases. The poor concordance with CAP and particularly weak performance in lean individuals-who represent a significant proportion of PWH-indicate that FLI cannot reliably identify HS in this population and should not be used as a standalone diagnostic tool.

PMID:41969132 | DOI:10.1097/QAI.0000000000003809

Palliat Support Care. 2026 Apr 13;24:e106. doi: 10.1017/S1478951526102211.

ABSTRACT

OBJECTIVE: Providing care for children with life-limiting conditions(LLCs) is an emotionally challenging experience that often exposes caregivers, particularly mothers, to considerable risk of psychological distress. The purpose of this study was to examine the moderating effect of emotional dysregulation on the relationship between severity of anxiety and depressive symptoms and high caregiving intensity, controlling for sociodemographic characteristics among mothers caring for children diagnosed with life-limiting conditions.

METHOD: Using a cross-sectional descriptive design, a convenience sample of 192 mothers caring for children with life-limiting conditions was recruited and filled out an online self-administered questionnaire. Data were collected using online self-administered questionnaires regarding the sociodemographic characteristics of mothers and their children, emotional regulation difficulties (DERS), and the levels of anxiety and depressive symptoms among the mothers (DASS-21).

RESULTS: The analysis showed that 21.4% and 7.8% of mothers had moderate and severe depressive symptoms, and 19.3% and 15.6% had moderate and severe anxiety symptoms, respectively. The analysis also showed that emotional dysregulation is associated with high levels of anxiety (β = 0.74, P < 0.001) and depression (β = 0.74, P < 0.001); however, there was no significant moderating effect.

SIGNIFICANCE OF RESULTS: Anxiety and depression are significant psychological distress among mothers caring for children with life-limiting conditions and can be aggravated by emotional dysregulation and caregiving burden. There is a need to integrate interdisciplinary teamwork and family-centered care to provide holistic care and offer early screening, detection, and emotional regulation-focused management programs for psychological distress at healthcare services that care for children with LLCs.

PMID:41969128 | DOI:10.1017/S1478951526102211

Palliat Support Care. 2026 Apr 13;24:e103. doi: 10.1017/S1478951526102193.

ABSTRACT

OBJECTIVE: Hospices represent the cornerstone of modern palliative services. However, population-level data on hospice utilization and characteristics of patients dying in hospice remain limited to examine national temporal trends in hospice deaths in Italy from 2011 to 2022, with a focus on the underlying causes of death.

METHODS: We performed a nationwide, population-based retrospective study using official mortality data from the Italian National Institute of Statistics. All deaths registered in Italy between 2011 and 2022 were included. Hospice deaths were identified as those occurring in licensed hospice facilities.

RESULTS: Hospice beds increased from 1,681 in 2011 to 3,419 in 2022, while hospice deaths more than doubled from 19,179 (3.2% of all deaths) to 43,972 (6.2%). The mean age of hospice deaths rose from 74.0 to 76.6 years. Among patients dying in hospice, neoplasms remained the leading cause of death but declined from 87.0% in 2011 to 73.8% in 2022, while cardiovascular deaths increased from 6.2% to 9.5%, neurological from 1.2% to 3.4%, and respiratory from 1.0% to 2.5%. The proportion of national neoplasm deaths occurring in hospice reached approximately 20% in 2022. Similarly, the proportion of non-neoplasm hospice deaths tripled (0.6-2.1%).

SIGNIFICANCE OF THE RESULTS: Between 2011 and 2022, hospice deaths in Italy more than doubled, reflecting substantial progress in expanding access to palliative care. The gradual increase in non-neoplasm hospice deaths suggests a shift toward greater inclusivity, although neoplasm remains predominant.

PMID:41969126 | DOI:10.1017/S1478951526102193

Palliat Support Care. 2026 Apr 13;24:e105. doi: 10.1017/S1478951526102120.

ABSTRACT

OBJECTIVES: Medical assistance in dying (MAID) is a rapidly growing and evolving field. The provision of MAID in Canada has substantially outpaced the number of new providers. While challenges of provision have been well described, little is known about the sustainability of providing this care long term. To fill this gap, we aimed to determine if providing MAID is sustainable while identifying factors that impact provider wellbeing.

METHODS: We developed a 20-item Likert scale-based questionnaire that focused on themes of sustainability. We performed descriptive analyses for each question and used Fisher’s exact and Kruskal-Wallis tests to assess differences across provider characteristics. The questionnaire was distributed via a network of MAID navigators and providers in Ontario, Canada.

RESULTS: In total, 38 responses were received from well-experienced clinicians in a variety of specialties. A total of 74% of respondents felt their MAID work was sustainable for the long term. Practitioners strongly enjoyed the work and reported little emotional toll and burnout. While some providers felt the compensation and training were sufficient, others felt it could be improved. Nearly all respondents had someone ethically and clinically knowledgeable about MAID they could go to for support.

SIGNIFICANCE OF RESULTS: Our questionnaire has shown clinicians who are well-experienced and connected to supports report very positive experiences providing MAID and view the work as sustainable. While existing literature and media often emphasize the challenges of MAID, the perspectives of providers highlight a positive experience.

PMID:41969123 | DOI:10.1017/S1478951526102120

New Microbiol. 2026 Apr;49(1):44-49.

ABSTRACT

This study characterized the clinical distribution and antimicrobial susceptibility of Burkholderia cepacia complex (BCC) isolates in the Shaoxing region. A total of 303 clinical BCC isolates collected from 15 healthcare facilities during 2023 were analyzed using MALDI-TOF MS for identification and VITEK 2 COMPACT for susceptibility testing, following CLSI 2023 guidelines (Clinical and Laboratory Standards Institute, 2023). B. cenocepacia (75.2%), B. multivorans (13.5%), and B. cepacia (6.9%) were the predominant species, while six isolates remained unidentified at the species level. Isolates were recovered primarily from male patients (58.1%), individuals over 65 years (70.0%), and ICU (intensive care unit) patients (59.7%). Respiratory specimens – including sputum, throat swabs, and bronchoalveolar lavage fluid – accounted for the majority of isolates (79.5%), followed by pleural/ascitic fluids and blood (11.9%), and urine (2.3%). B. cenocepacia was more prevalent in male patients (63.6%), whereas B. multivorans and B. cepacia predominantly affected females, accounting for 63.4% and 61.9% of cases, respectively (p = 0.001). Regarding age distribution, the majority of patients across all three species were over 65 years of age, with no statistically significant difference observed among the groups (p = 0.713). Significant associations were also found between species and both hospital setting (p = 0.020) and specimen type (p<0.001). All three major species exhibited high susceptibility (>90%) to ceftazidime, with no significant differences among them. In contrast, statistically significant differences (P<0.05) were observed in the susceptibility rates of B. cenocepacia compared to the other two species toward minocycline, meropenem, levofloxacin, and trimethoprim-sulfamethoxazole. These results highlight the necessity of AST (Antimicrobial Susceptibility Testing)-guided therapy to optimize treatment and limit resistance development.

PMID:41969112

Ann Med. 2026 Dec;58(1):2656557. doi: 10.1080/07853890.2026.2656557. Epub 2026 Apr 13.

ABSTRACT

BACKGROUND: Children are a particularly vulnerable population for tuberculosis (TB). The present study aims to describe epidemiological characteristics and temporal trends of paediatric TB in Spain.

METHODOLOGY: A retrospective study of paediatric TB in Spain was conducted using data from the National Epidemiological Surveillance Network and the l Basic Minimum Data Set of Hospitalizations from 2012 to 2023. Trends of annual notification rates (NR), hospitalization rates (HR) and annual percentage of change (APC) were calculated.

RESULTS: Between 2012 and 2023 there were 3,472 reported cases and 2,768 hospitalizations. The mean NR and HR of the period were 4.2 and 3.3 per 100,000 inhabitants, respectively. The NR and the HR decreased from 5.0 to 3.5 and from 5.0 to 2.8, with significant APCs of -5.05 and -7.25, respectively. The most affected age group was 1-4 (39.8% of notifications and 43.4% of hospitalizations). Severe presentations (miliary and meningitis) were more common amongst cases less than 1-year-old.

CONCLUSIONS: A decreasing trend in paediatric TB in Spain has been observed since 2012, with a slight rebound since 2021. Younger children aged 1-4 had the highest incidence while children under 1 year had the highest percentage of severe TB. This highlights the importance of prioritizing and strengthening control strategies in this age group.

PMID:41969056 | DOI:10.1080/07853890.2026.2656557