Category: Statistics

Eur J Nucl Med Mol Imaging. 2026 Aug 11. doi: 10.1007/s00259-026-08079-8. Online ahead of print.

ABSTRACT

PURPOSE: The DOSISPHERE-01 study demonstrated a survival benefit for patients treated with ⁹⁰Y radioembolization using personalised [^99mTc]Tc-MAA guided versus standard dosimetry guided treatment. This ancillary analysis complements DOSISPHERE-01 by reporting post-treatment dosimetry and assessing agreement between predictive ([^99mTc]Tc-MAA) and post-treatment (⁹⁰Y) absorbed doses.

MATERIALS AND METHODS: All DOSISPHERE-01 patients with both pre-treatment [^99mTc]Tc-MAA SPECT/CT and post-treatment ⁹⁰Y imaging were eligible. Multicompartment dosimetry was performed using two segmentation methods: anatomic (MRI/CT) and count-threshold based (SPECT). Mean normal liver tissue and index-lesion absorbed dose, and dose volume histogram (DVH) metrics were determined using Simplicit⁹⁰Y (Mirada Medical, Oxford UK). Agreement between [^99mTc]Tc-MAA and ⁹⁰Y absorbed doses was assessed via Bland-Altman and paired-sample analysis, with correlation assessed via linear-regression.

RESULTS: Thirty-seven patients were included: 19 from the personalised arm and 18 from the standard dosimetry arm. Pre- and post-treatment absorbed dose differences were not statistically significant for the index lesion (241 Gy vs. 229 Gy, p = 0.15; mean difference 11.9 Gy; 95% LoA – 84.3 to 108.2 Gy), Perfused Volume Normal Liver Tissue (PVNT) (91 Gy vs. 99 Gy, p = 0.14; mean difference – 8.2 Gy; 95% LoA – 71.6 to 55.1 Gy), or DVH metrics (V200, D70, D50) using anatomic segmentation. Corresponding metrics were significantly different using count-threshold segmentation (p < 0.05). For both methods, pre- and post-treatment mean index lesion and PVNT absorbed doses, and V200, D70, D50 were strongly correlated (Pearsons Correlation Coefficient > 0.65, p < 0.05).

CONCLUSION: ⁹⁰Y absorbed dose outcomes in the DOSISPHERE-01 study corresponded closely with [^99mTc]Tc-MAA predictive dosimetry, confirming the validity of [^99mTc]Tc-MAA for dosimetry-based treatment planning in this clinical scenario. Agreement was maximised using anatomic segmentation.

PMID:42576071 | DOI:10.1007/s00259-026-08079-8

Aesthetic Plast Surg. 2026 Aug 10. doi: 10.1007/s00266-026-06211-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This article aims to evaluate the application value of augmented reality (AR)-assisted surgical navigation in perpendicular plate of ethmoid bone (PPE) resection teaching, assessing the extent to which AR improves medical trainees’ mastery of PPE anatomical localization and surgical navigation, and providing a standardized training method.

METHODS: PPE osteotomy lines were designed and integrated into an AR navigation system that superimposes virtual guidance onto the surgical field using HoloLens 2 AR glasses. Ten participants (five clinical medical students and five non-clinical students) were instructed to localize five anatomical points on the PPE of eight cranial models, both manually and with AR guidance. Teaching effect was evaluated via statistical analysis of localization accuracy and operation time.

RESULTS: AR-assisted navigation significantly improved the accuracy of the safety harvesting area points of PPE localization in both groups. Clinical group trainees demonstrated higher accuracy than non-clinical group trainees, both when using AR and not using AR. However, AR guidance prolonged annotation time due to participants reassessing anatomical landmarks. Point E consistently exhibited the greatest deviation, suggesting that it is a critical anatomical landmark during PPE harvest.

CONCLUSION: Integrating AR technology into simulated PPE resection training may enhance trainees’ spatial positioning accuracy and reduce experience-related variability. While current limitations exist in projection alignment and system fidelity, AR serves as a feasible auxiliary educational tool for PPE resection. As a preliminary simulation study, it provides a technical foundation for trainees to master complex landmarks prior to clinical practice.

LEVEL OF EVIDENCE V: Experimental simulation study: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

PMID:42576063 | DOI:10.1007/s00266-026-06211-5

Aesthetic Plast Surg. 2026 Aug 10. doi: 10.1007/s00266-026-06199-y. Online ahead of print.

ABSTRACT

BACKGROUND: Hairline lowering (HALO) surgery is commonly performed using either a single anterior incision (AI) placed along the hairline or an anterior incision combined with bilateral extensions (BE) oriented anteroposteriorly along the superior temporal lines. The biomechanical implications of these incision designs remain insufficiently defined.

METHODS: Cadaveric dissections were performed on five heads. After placement of an AI and subgaleal release, maximal scalp advancement was measured in the midline and along both mid-pupillary lines. Subsequently, bilateral extensions were added, together with additional posterior subgaleal dissection and one additional galeotomy, and measurements were repeated. Statistical analysis compared advancement achieved with each incision design.

RESULTS: The BE design demonstrated greater scalp advancement at all measurement points compared with the AI design. Midline advancement increased by 21% (P = 0.043), right mid-pupillary advancement by 24.29% (P = 0.048), and left mid-pupillary advancement by 28.15% (P = 0.048). The most pronounced qualitative difference was observed at the lateral endpoints of the hairline, where BE allowed substantially greater advancement than AI; however, this observation was not quantitatively measured.

CONCLUSIONS: This cadaveric study provides preliminary anatomical evidence suggesting that the BE incision design may allow greater scalp advancement than the AI technique, particularly at the lateral hairline endpoints. These findings should be interpreted with caution given the small sample size and the presence of additional release maneuvers in the BE group. Further clinical studies are warranted to validate these anatomical observations.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:42576061 | DOI:10.1007/s00266-026-06199-y

Support Care Cancer. 2026 Aug 10;34(9):838. doi: 10.1007/s00520-026-11074-2.

ABSTRACT

PURPOSE: Chemotherapy-induced sensory alterations are common and may negatively affect nutritional status, treatment adherence and quality of life in people with cancer. However, inter-individual variability in these alterations remains poorly understood. This study examined whether personality traits, food neophobia, disgust sensitivity, and sensitivity to reward, contribute to variability in self-reported sensory alterations during chemotherapy.

METHODS: A longitudinal study was conducted in 95 patients undergoing chemotherapy, assessed at baseline (T0) and after nine weeks of treatment (T1). Sensory alterations were measured using a modified version of the Chemotherapy-Induced Taste Alteration Scale, and personality traits were assessed with validated questionnaires. Changes over time were evaluated using repeated-measures analyses, while associations between predictors and outcomes were examined using ANCOVA and multivariable logistic regression models.

RESULTS: After nine weeks, the prevalence of self-reported sensory alterations increased across all domains (24-60%). Discomfort, nausea, phantogeusia/parageusia and general taste alterations were the most frequently reported symptoms. Personality traits were significantly associated with several outcomes. Food neophobia was positively associated with the likelihood of reporting general taste alterations. In contrast, sensitivity to reward was consistently inversely associated with phantogeusia/parageusia and nausea.

CONCLUSIONS: Personality traits are associated with individual differences in chemotherapy-induced chemosensory alterations. Identifying at-risk patients may support targeted nutritional and behavioural interventions to improve treatment tolerance and well-being.

PMID:42576055 | DOI:10.1007/s00520-026-11074-2

Cancer Gene Ther. 2026 Aug 10. doi: 10.1038/s41417-026-01065-0. Online ahead of print.

ABSTRACT

Breast cancer (BRCA) development is tightly linked to metabolic dysregulation, with enhanced aerobic glycolysis standing out as a key hallmark, and competing endogenous RNA (ceRNA) mechanisms have emerged as critical epigenetic regulators of tumor metabolic pathways-this study thus aimed to explore glycolytic regulation through ceRNA networks in BRCA, with the goal of identifying potential prognostic biomarkers and mechanistic targets. To achieve this, we integrated comprehensive bioinformatics analyses of The Cancer Genome Atlas (TCGA) dataset with experimental validation to identify PCAT7 as a functionally relevant long non-coding RNA (lncRNA), complemented by functional assays including cell proliferation tests, glucose consumption measurements, and lactate production assays, as well as molecular interaction verification using luciferase reporter assays and RNA immunoprecipitation (RIP). Our results showed that PCAT7 is overexpressed in BRCA tissues and correlates with poor patient prognosis; mechanistically, PCAT7 acts as a molecular sponge for miR-204-5p, alleviating its inhibitory effect on RUNX2 and thereby regulating key glycolytic regulators including GLUT1 and PKM2, while silencing PCAT7 suppresses tumor cell proliferation, invasion, migration, and glycolytic activity in vitro. Collectively, this study uncovers a novel ceRNA network involving PCAT7/miR-204-5p/RUNX2 that drives glycolytic metabolism in BRCA, advancing our understanding of epigenetic regulation in cancer metabolism and highlighting PCAT7 as a potential prognostic biomarker for BRCA patients, with future in vivo studies needed to further validate the therapeutic potential of targeting this axis. Created in https://BioRender.com .

PMID:42576052 | DOI:10.1038/s41417-026-01065-0

Nat Genet. 2026 Aug 10. doi: 10.1038/s41588-026-02692-x. Online ahead of print.

ABSTRACT

The incidence of colorectal cancer (CRC) has risen in recent decades, with a disproportionate increase observed among younger individuals in Japan and other countries. The etiological contribution of the gut microbiota to CRC pathogenesis is recognized, yet the mechanisms involved remain to be fully clarified. Here we integrated whole-genome sequencing (WGS) and transcriptome profiling of CRC with whole-genome metagenomic sequencing of fecal samples to interrogate host-microbiome interactions at high resolution. Application of interpretable artificial intelligence enabled the stratification of CRC into four distinct microbiome-informed subtypes. WGS analysis identified mutational signatures SBS88 and ID18, linked to colibactin exposure, as early clonal events detected in 44.8% of non-hypermutated patients. Notably, these signatures were significantly more frequent among patients born after the 1960s. Microbiome-based subclassification revealed subtype-specific clinical and molecular features. Collectively, our findings indicate that colibactin exposure constitutes a prevalent and potentially modifiable risk factor for CRC in the Japanese population.

PMID:42576026 | DOI:10.1038/s41588-026-02692-x

Nat Rev Genet. 2026 Aug 10. doi: 10.1038/s41576-026-00992-w. Online ahead of print.

ABSTRACT

The widespread adoption of electronic health records (EHRs), which capture patient-specific longitudinal information on diagnoses, laboratory tests, clinical procedures, and outcomes, has created unprecedented opportunities to study diseases at scale. Integrating EHR data with genomic information offers novel ways to understand disease heterogeneity, identify biomarkers and therapeutic targets, and predict disease risk to improve clinical decision-making at scale. Recent methodological advances in machine learning (ML) and artificial intelligence (AI) can handle data with high dimensionality, high levels of noise, and irregular temporality better than traditional statistical approaches. Progress in EHR-linked biobank development, data standardization pipelines, and architectures for modelling and implementation have accelerated the advancement of the field and warrant an assessment of current capabilities and limitations. This Review highlights AI and ML frameworks for integrating genomic, multi-omics, and EHR data, and discusses how these approaches are reshaping genomics research as well as clinical practice.

PMID:42576006 | DOI:10.1038/s41576-026-00992-w

J Bone Miner Metab. 2026 Aug 10. doi: 10.1007/s00774-026-01747-7. Online ahead of print.

ABSTRACT

INTRODUCTION: In cortical bone histology, the ratio of Haversian canal and secondary osteon areas reflects bone resorption and formation during metabolic events executed by Basic Multicellular Units (BMUs). Area data can be pooled where they are collected independently, and the ratio calculated from the mean of each measure. They can also be paired, where they are measured from the same secondary osteon at once and the mean of individual ratios is calculated. We evaluate the impact of pooling and pairing on the resulting ratio values and their interpretation of bone remodelling.

MATERIALS AND METHODS: Using both approaches, we calculated the area ratio of 551 Haversian canals and secondary osteons from measurements of existing midshaft femur histology slides. The sample represents n = 38 young and middle-aged females of different social backgrounds from a historical osteological collection. Univariate and bivariate statistics were used to compare and evaluate paired and pooled values and their differences.

RESULTS: The pooled method usually returned a lower canal-to-osteon value than paired data across the whole sample, ages, and social groups. These methods differed in the ratios they produced, independently of the number of measurements per sample.

IN CONCLUSION: The pooling technique indicated the presence of thicker lamellar bone within secondary osteons, suggesting greater quantities of bone formed during BMU activity, than the paired technique results, which suggested less bone formed per BMU. While pooling offers efficiency in data collection and analysis, we show that paired data yield more biologically precise and analytically flexible results at an individual BMU level.

PMID:42576001 | DOI:10.1007/s00774-026-01747-7

Nat Nanotechnol. 2026 Aug 10. doi: 10.1038/s41565-026-02235-9. Online ahead of print.

ABSTRACT

Gut microbial metabolites play crucial roles in regulating systemic immunity, but their mechanisms and limited drug-like properties remain unresolved. Here we report an oral nano-formulation that leverages gut microbial metabolites to modulate T cell metabolism and amplify antitumour immunity. Through an in vitro screening of gut microbial metabolites, we identified 3,4-dihydroxybenzoic acid that improved adoptive T cell therapy and enhanced CD8⁺ T cell stemness by suppressing glycolysis and regulating the Akt-mTORC1-Myc pathway. To harness the potency of 3,4-dihydroxybenzoic acid for systemic cancer immunotherapy, we engineered a 3,4-dihydroxybenzoic acid prodrug nano-emulsion, significantly increasing its oral absorption and half-life. In multiple murine tumour models, the oral nano-emulsion enhanced the expansion of antigen-specific, stem-like CD8⁺ T cells, sensitizing tumours to anti-PD-1 blockade and exerting robust antitumour efficacy. By integrating nanotechnology with microbial-metabolite-based immunotherapy, this study establishes a mechanistic link between the gut microbiota and T cell immunity, offering a promising approach for cancer immunotherapy.

PMID:42575976 | DOI:10.1038/s41565-026-02235-9

Sci Rep. 2026 Aug 11;16(1):24905. doi: 10.1038/s41598-026-66191-z.

ABSTRACT

Despite their well-known efficacy, forced-air warming during operations has its drawbacks, mainly high energy consumption and risk of hyperthermia. We therefore investigated two warming strategies in a prospective randomized study with the aim of reducing the incidence of hyperthermia without increasing the risk of intraoperative hypothermia. In the standard of care group temperature of the forced-air warmer was reduced to 32 °C when core temperature reached 37.3 °C. In the modified warming group this reduction was performed when core temperature reached 36.5 °C. The difference in the duration of normothermia between standard of care and the modified warming strategy was estimated to be 3.9% (90%-CI: 0.8% to 7.1%) and was within the predefined equivalence bounds of ± 20% (p < 0.001). In both treatment groups no intraoperative hyperthermia ocurred. Average energy consumption per hour was significantly higher in the standard-of-care group (0.51 kWh/h; 95%-CI: 0.47-0.56) compared with the modified warming strategy (0.40 kWh/h; 95%-CI: 0.35-0.46; p = 0.002). By strictly limiting the heat supply, intraoperative hyperthermia can be safely prevented during craniotomies. A lower threshold value of 36.5 °C allows for a meaningful reduction in energy consumption.

PMID:42575948 | DOI:10.1038/s41598-026-66191-z