Category: Statistics

Bull Math Biol. 2026 Jun 3;88(6):101. doi: 10.1007/s11538-026-01663-x.

ABSTRACT

This study develops a behavior-disease feedback model grounded in imitation dynamics to analyze optimal long-term epidemic coexistence strategies from both static and dynamic perspectives. Analytical findings reveal that the stability of the system depends on both the basic reproduction number and the behavioral threshold, with the latter and risk attention jointly determining optimal static intervention intensity. Data-driven analyses of influenza (Shanxi) and COVID-19 (Shanghai) show that adaptive public behavior can drive recurrent epidemic waves. In dynamic optimization simulations involving control of transmission rate alone or jointly with behavioral threshold, key insights include: seizing the critical rapid-growth window prevents both strategy oscillations and epidemic rebound resulting from delayed intervention; faster public response lowers both control costs and infection burden while accelerating attainment of control goals; stricter prevalence constraints require earlier and longer interventions, where proactive phased strategies outperform short, high-intensity measures in cost-effectiveness; achieving lower target prevalence necessitates earlier action and greater public caution, advancing the infection peak but substantially reducing its magnitude. These results offer a theoretical framework and practical insights for optimizing resource allocation and guiding policy in endemic disease management.

PMID:42234344 | DOI:10.1007/s11538-026-01663-x

Vet Res Commun. 2026 Jun 3;50(5):361. doi: 10.1007/s11259-026-11297-y.

ABSTRACT

This study evaluated the safety and feasibility of gasless laparoscopic cholecystectomy in dogs, identifying factors associated with surgical time and survival. Twenty-five dogs with symptomatic gallbladder disease-predominantly gallbladder mucocele (72.0%) and cholelithiasis-underwent cholecystectomy using a mechanical abdominal wall lift system. Variables including gallbladder volume, age, body condition score, and intraoperative complications were recorded. Statistical analyses employed Pearson’s chi-squared, Spearman’s correlation, regression analysis for surgical time predictors, and Kaplan-Meier survival analysis with log-rank tests. No significant association was found between breed and biliary condition. However, surgical time was significantly and positively correlated with body weight and body condition score (p < 0.001). Linear regression indicated that each 1 kg increase in body weight added approximately 4 min to the procedure. Gallbladder volume did not correlate with surgical duration. Survival analysis revealed that dogs with gallbladder mucocele had a significantly lower probability of overall survival compared to cholelithiasis (p = 0.014). The results demonstrate that the gasless laparoscopic cholecystectomy is a viable and safe alternative for canine patients, especially those at a high cardiorespiratory risk. While increased body weight is a critical predictor of prolonged surgery, the primary biliary pathology remains the most significant determinant of survival.

PMID:42234328 | DOI:10.1007/s11259-026-11297-y

Radiol Phys Technol. 2026 Jun 3. doi: 10.1007/s12194-026-01070-w. Online ahead of print.

ABSTRACT

This study compared a dose-volume histogram-based machine learning (ML) approach with a three-dimensional dose distribution-based convolutional neural network (CNN) approach for volumetric-modulated arc therapy planning in head and neck cancer (HNC). Sixty-five patients who underwent whole-neck radiotherapy were retrospectively analyzed; 55 cases were used for model training and 10 for independent testing. Treatment plans generated by the CNN-based framework and a commercial ML-based planning system (RapidPlan) were evaluated using dose-volume indices (DVIs) and blinded qualitative scoring. In the DVI analysis, the ML-based plans achieved significantly higher target coverage than both the CNN-based and clinical plans. In contrast, the CNN-based plans maintained a mean error of less than 2% relative to the clinical plans, indicating close agreement with the clinical standard. No statistically significant differences in organs-at-risk dose metrics were observed among the three approaches. In the blinded qualitative evaluation, mean scores were 4.7 ± 0.56, 4.0 ± 1.07, and 2.7 ± 0.90 for the clinical, CNN-based, and ML-based plans, respectively, with the ML-based plans receiving significantly lower scores. These findings indicate that differences in prediction methodology and optimization strategy influence final plan quality, particularly with respect to spatial dose characteristics. Three-dimensional dose distribution-based prediction may provide clinical advantages for automated radiotherapy planning in HNC.

PMID:42234324 | DOI:10.1007/s12194-026-01070-w

Mol Biol Rep. 2026 Jun 3;53(1):878. doi: 10.1007/s11033-026-12052-x.

ABSTRACT

BACKGROUND: Recent studies have emphasized the role of adenosine receptors (ADORs) in the malignant biological behaviors. Therefore, the expression and clinical significance of four subtypes of ADORs (ADORA1, ADORA2A, ADORA2B, and ADORA3) in ovarian tumors were analyzed.

METHODS AND RESULTS: The expression of ADORs in 24 pairs of ovarian tumor tissues and adjacent non-tumor tissues was measured by quantitative real-time PCR. The correlations between the investigated parameters and clinicopathological features were statistically tested. The diagnostic accuracy of ADORs was assessed using receiver operating characteristic curve analysis. Kaplan-Meier method was used to estimate the influence of ADORs expression on the prognosis of patients. Ovarian tumors showed higher expression of ADORA2A (1.5-fold), ADORA2B (2.2-fold), and ADORA3 (2.3-fold), but not ADORA1, compared to normal tissues. High expression of ADORA1 and ADORA2A was associated with younger age (≤ 48.5 years; P = 0.034) and clinical stage III-IV (P = 0.050), respectively. ADORA2B also showed moderate accuracy in ovarian tumors diagnosis (P = 0.001). Survival analyses further demonstrated that high expression of ADORA1 (P = 0.012) and ADORA2B (P = 0.027) was correlated with worse overall survival. Moreover, high ADORA3 expression (P = 0.042) was associated with poor post-progression survival.

CONCLUSIONS: Our results demonstrated that adenosine A2A, A2B, and A3 receptors were differentially expressed between ovarian tumors and paired non-tumor tissues, and that ADORs may be clinically useful biomarkers for diagnosis and outcome prediction in ovarian cancer.

PMID:42234312 | DOI:10.1007/s11033-026-12052-x

Int Urol Nephrol. 2026 Jun 3. doi: 10.1007/s11255-026-05218-w. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the potential role of human papillomavirus (HPV) in early onset prostate cancer (PCa) through HPV-DNA detection and genotyping, and immunohistochemical evaluation of p16^INK4a expression.

METHODS: This retrospective cross-sectional study included patients diagnosed with PCa at ≤ 55 years of age between 2010 and 2021. Patients with a familial history of PCa, incomplete medical records, immunodeficiency, or insufficient tissue for molecular analysis were excluded. Formalin-fixed, paraffin-embedded (FFPE) prostate biopsy samples were analyzed for HPV-DNA using the HPV 3.5 LCD-Array Kit (Chipron GmbH, Berlin, Germany), a multiplex PCR-based assay targeting 32 HPV genotypes. Immunohistochemical staining for p16^INK4a was performed to assess its expression. Clinical data, including PSA levels, Gleason score, ISUP grade, and EAU risk group, were compared between HPV-positive and HPV-negative cases.

RESULTS: HPV-DNA was detected in 12 of 45 cases (26.7%), with genotype 62 being the most frequent. Multiple HPV genotypes were identified in three cases (6.7%). p16^INK4a immunopositivity was observed in 91.7% of HPV-positive tumors compared with 69.7% of HPV-negative tumors (p = 0.240). HPV-positive patients showed higher ISUP grades than HPV-negative patients (p = 0.029) and were more likely to be in intermediate or high-risk groups (p = 0.028). No significant differences were observed in PSA levels or Gleason scores.

CONCLUSION: The detection of HPV-DNA in a considerable proportion of early onset PCa specimens, together with the more frequent but not statistically significant p16^INK4a positivity in HPV-positive tumors, suggests a possible association with prostate tumor biology. However, the presence of low-risk HPV genotypes and the non-specific nature of p16^INK4a expression complicate the interpretation of a direct oncogenic role.

PMID:42234298 | DOI:10.1007/s11255-026-05218-w

Vet Res Commun. 2026 Jun 3;50(5):362. doi: 10.1007/s11259-026-11301-5.

ABSTRACT

The present study represents the first detailed report of Yersinia ruckeri infection in farmed rainbow trout (Oncorhynchus mykiss) from the Indian Himalayan Region, where intensification of aquaculture has elevated the pathogen load and transmission dynamics, causing occurrence of enteric redmouth disease (ERM). The study examined infections by Y. ruckeri, RTACP-14 A (PX411334), in farmed rainbow trout from the Indian Himalayas. Affected fish displayed clinical signs such as hemorrhagic mouth, deep ulceration at caudal peduncle region, fin degeneration, lesions, black pigmentation, and erratic swimming behaviour. The isolated Y. ruckeri RTACP-14 A strain was identified through biochemical tests and confirmed by 16 S rRNA sequencing showing the closest evolutionary relationship (100) to Y. ruckeri strain BY-1Y. Virulence analysis revealed β-hemolysis, low hydrophobicity, and substantial biofilm formation under glucose-rich conditions. The cumulative mortality increased from 12.5% at day 1 to 83% by day 32 during a controlled experimental infection trial conducted in rainbow trout. Antibiotic susceptibility test showed that Y. ruckeri RTACP-14 A was sensitive to most antibiotics, with imipenem, fosfomycin, and ciprofloxacin exhibiting the largest inhibition zones (> 40 mm), while bacitracin was the only antibiotic to which resistance was observed. The lowest minimum inhibitory concentrations (MICs) were recorded for oxytetracycline (0.125 µg mL^{– 1}), florfenicol (1 µg mL^{– 1}), and tobramycin (1 µg mL^{– 1}). Histopathological analysis revealed gill hyperplasia, intestinal villus necrosis, kidney damage, liver congestion, and muscle degradation, with distinct patterns distinguishing acute from chronic infections. To mitigate outbreaks of enteric red mouth disease caused by Y. ruckeri, trout farmers should adopt best management practices, including maintaining optimal water quality, minimizing handling stress, implementing strict biosecurity measures, and using antimicrobials judiciously within a regulated framework. These measures are essential for safeguarding fish health and welfare, minimizing economic losses, and ensuring the sustainability of trout farming in the region.

PMID:42234297 | DOI:10.1007/s11259-026-11301-5

J Med Syst. 2026 Jun 3;50(1):90. doi: 10.1007/s10916-026-02386-1.

ABSTRACT

Long QT syndrome (LQTS) is a primary risk factor for ventricular arrhythmias and sudden cardiac death in children. Accurate corrected QT intervals (QTc) measurement is imperative but challenging for non-heart-rhythm specialists, especially in children. We developed and evaluated pedQTNet, a deep neural network model for estimating QTc and detecting LQTS in pediatric patients. We analyzed a cohort of 37,992 patients aged 0-18 years with 65,370 ECGs annotated by pediatric electrophysiologists (PEPs) between 2010 and 2020. Using PEP-annotated QTc measurements as ground truth, pedQTNet was trained and calibrated on raw ECG waveforms to optimize QTc estimation and LQTS classification. Performance was compared to GE Healthcare’s Marquette 12SL algorithm, and to PEPs in cross-validation, as well as an additional prospective set of 200 ECGs. In 10-fold cross-validation, pedQTNet estimated QTc’s with a mean absolute error (MAE) of 18.8 ms (95% CI: 18.4-19.2) and predicted LQTS at 470 ms with 85% sensitivity (83%-87%), 87% specificity (87%-88%), positive likelihood ratio (PLR) of 6.7 (6.5-7.0), and negative likelihood ratio (NLR) of 0.17 (0.15-0.19), outperforming Marquette 12SL. In the prospective set, pedQTNet had higher sensitivity than PEPs (100% [69%-100%] vs. 71% [53%-85%], P < 0.05), and a lower but not statistically significant NLR (0.00 [0.00-0.70] vs. 0.30 [0.18-0.50], P = 0.2). PedQTNet demonstrated high QTc estimation accuracy and reliable LQTS detection, outperforming a commercial tool and on par with expert interpretation. Its strong performance supports its clinical use for scalable, automated pediatric ECG screening and LQTS risk assessment, offering a practical tool for enhancing pediatric cardiac care.

PMID:42234295 | DOI:10.1007/s10916-026-02386-1

Clin Transl Oncol. 2026 Jun 3. doi: 10.1007/s12094-026-04412-7. Online ahead of print.

ABSTRACT

BACKGROUND: Breast and gynaecological cancers represent the leading oncological burden among women worldwide. We aimed to describe long-term mortality trends for these malignancies in Spain over a 26 year period, focusing on differences between early-onset (< 50 years) and late-onset (≥ 50 years) disease.

METHODS: Mortality data (1999-2024) were obtained from the Spanish National Institute of Statistics. Age-standardised mortality rates (ASMRs) were calculated per 100,000 women using the 2013 European Standard Population. Joinpoint regression estimated annual percentage changes (APC) and average annual percentage changes (AAPC) with 95% confidence intervals (CI).

RESULTS: Total annual deaths rose from 9531 to 11,641, despite declining ASMRs for most sites. Breast cancer mortality decreased consistently (AAPC – 1.4%; 95% CI – 1.5, – 1.3), with a more pronounced reduction in the < 50 group (AAPC – 2.5%). Significant ASMR declines were observed for uterus NOS (- 2.3%), ovary (- 0.7%), and cervix uteri (- 0.6%). In the < 50 cohort, ovarian cancer mortality fell sharply (AAPC – 2.1%). Conversely, corpus uteri cancer was the only site showing an increasing trend (AAPC + 0.4%; 95% CI 0.1, 0.8), with a steeper increase observed among women ≥ 50 years. Non-monotonic trends were identified for less common gynaecological cancers.

CONCLUSIONS: Mortality rates for breast and most gynaecological cancers in Spain have declined, although absolute deaths have increased. These trends are potentially consistent with advances in prevention and care alongside population ageing. The rise in corpus uteri cancer represents an emerging public health concern potentially associated with increasing metabolic risk factors, highlighting the need for targeted prevention strategies.

PMID:42234293 | DOI:10.1007/s12094-026-04412-7

Neurosurg Rev. 2026 Jun 3;49(1):430. doi: 10.1007/s10143-026-04347-1.

ABSTRACT

Anterior lumbar interbody fusion (ALIF) is widely used for degenerative lumbar disc disease, offering restoration of disc height and sagittal alignment. However, pseudarthrosis remains a relevant complication, and the benefit of supplemental posterior fixation over stand-alone constructs is still debated. To compare the incidence of pseudarthrosis following stand-alone ALIF versus ALIF combined with posterior pedicle screw fixation. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42024581358). PubMed/MEDLINE, Embase, Cochrane Library, and BVS were searched for studies published between 2013 and September 2024. Clinical studies including patients with degenerative lumbar disease undergoing ALIF with at least 12 months of follow-up were eligible. Study selection and data extraction were performed independently by two reviewers. Risk of bias was assessed using the Joanna Briggs Institute (JBI) tool for observational studies and Risk of Bias 2 (RoB 2) for randomized trials. Random-effects models were used to estimate pooled pseudarthrosis prevalence and clinical outcomes. Fourteen studies comprising 917 patients and over 1,000 operated levels were included. The pooled prevalence of pseudarthrosis was 8.17% (95% CI: 5.04-11.31), with substantial heterogeneity (I²=70.8%). Pseudarthrosis rates were numerically higher in stand-alone ALIF (8.95%; 95% CI: 4.54-13.37) compared with ALIF combined with posterior fixation (6.76%; 95% CI: 3.58-9.94), although the difference was not statistically significant (p = 0.429). Significant clinical improvement was observed, with a mean reduction of 4.16 points in VAS and a 24.46-point improvement in ODI. Meta-regression demonstrated no association between pseudarthrosis rates and clinical outcomes. Notably, stand-alone ALIF was associated with a significantly higher risk of reoperation for symptomatic pseudarthrosis (RR 6.8; 95% CI: 1.9-24.5; p < 0.01). ALIF provides substantial pain relief and functional improvement, with a relatively low overall rate of pseudarthrosis. Although stand-alone constructs showed a trend toward higher pseudarthrosis rates without statistical significance, they were associated with a markedly increased risk of reoperation. These findings suggest that, while fusion rates may appear comparable, supplemental posterior fixation may confer greater mechanical reliability and reduce clinically meaningful failure in selected patients.

PMID:42234274 | DOI:10.1007/s10143-026-04347-1

Int J Cardiovasc Imaging. 2026 Jun 3. doi: 10.1007/s10554-026-03744-3. Online ahead of print.

ABSTRACT

To compare different methods for myocardium quantification and exploratively evaluate the prognostic relationship between PET-measured viable myocardium and clinical outcomes in coronary artery disease (CAD) patients with ischemic cardiomyopathy (ICM). 183 CAD patients who underwent one-day ¹³NH₃ and ¹⁸F-FDG PET/CT myocardial viability assessment were retrospectively enrolled. Using Corridor4DM software, different types of myocardium (viable, normal, scar) were quantified via visual analysis, semi-quantitative scoring, and software automatic quantification. As an exploratory secondary analysis, patients were grouped and method-dependent grouping differences were analyzed. The correlation between viable myocardium, treatment decisions, and prognosis was retrospectively evaluated. Software identified the most normal myocardium and the least viable myocardium, while semi-quantitative scoring was the opposite. High inter-method consistency (all ICC>0.75) was observed, in which visual and software analyses showed optimal agreement, contrasting with scoring analysis. No significant differences were found among when viable myocardium<20%, but scoring analysis underestimated viable myocardium as its extent increased (P<0.001). Notably, all three methods exhibited concordant and comparable prognostic predictive value (AUC: 0.595-0.669 for OS and 0.529-0.533 for MACE). And exploratory prognostic analysis (n = 113) revealed no statistically significant interaction between treatment strategy and viability for either OS or MACE. However, a potential trend was observed where revascularization was associated with improved outcomes specifically in patients with a higher extent of viable myocardium (≥ 37%). Three analyses demonstrated high consistency in myocardium quantification, with visual and software analysis showing optimal agreement. Software analysis enhances clinical efficiency, offering improved sensitivity and objectivity. Furthermore, the three methods showed concordant prognostic predictive value; While exploratory analyses suggested potential prognostic trends, no statistically significant interaction was found between treatment strategy and viability. Accurately assessing viable myocardium via software automatic quantification offers an objective tool for assessment, though its role in guiding treatment decisions requires further validation.

PMID:42234272 | DOI:10.1007/s10554-026-03744-3