Category: Statistics

J Cancer Educ. 2026 Apr 9. doi: 10.1007/s13187-026-02872-7. Online ahead of print.

ABSTRACT

Use of integrative oncology (IO) has increased substantially, with a majority of cancer patients reporting use of integrative therapies alongside conventional treatment. Despite growing patient demand and expansion of integrative services at cancer centers, structured educational pathways for oncology providers remain limited. This national needs assessment evaluated interest in IO training and identified perceived barriers and priorities for curriculum development. An 18-question survey was distributed nationally to hematology/oncology, radiation oncology, and palliative care program directors, physicians, fellows, and internal medicine residents planning to enter these specialties. Programs were identified through the Accreditation Council for Graduate Medical Education (ACGME). Surveys were sent electronically with informed consent and distributed weekly for two 4-week sessions. Descriptive statistics were used to summarize responses. A total of 208 eligible participants responded to survey. The majority (71.6%) considered IO valuable or essential, meanwhile expressing interest in formal education (64.2%) in IO education. Most respondents had little or no prior integrative medicine training (85.4%). Program directors endorsed the training at valuable (50%) or essential (13.3%). Key barriers included lack of curriculum, limited faculty expertise, inadequate funding, and time constraints. Participants preferred certificate programs (48%) or fellowship distinction tracks (44%) over a standalone IO fellowship. This national needs assessment demonstrates a national training gap and support the development of structured, scalable educational pathways in integrative oncology.

PMID:41951997 | DOI:10.1007/s13187-026-02872-7

Saudi Dent J. 2026 Apr 8;38(4):45. doi: 10.1007/s44445-026-00166-8.

ABSTRACT

The color degradation of ocular prostheses is significantly affected by exposure to ultraviolet (UV) light over time. As a result, the prosthesis requires frequent replacement, ultimately increases the financial burden of rehabilitation on the patient. This study aimed to determine the optimal bisoctrizole percentage for ocular acrylic by assessing its effects on color stability after 300 h of artificial aging and on surface hardness. A total of 120 specimens were prepared from white heat-cure scleral acrylic and subdivided into two groups according to the conducted tests; color stability and surface hardness. Each of these groups were further subdivided into 6 groups with 10 specimens for each based on the weight percentages of bisoctrizole added; 0%, 0.5%, 1%, 1.5%, 2% and 2.5%. The color parameters were measured before and after artificial weathering using a portable digital colorimeter according to the CIE L*a*b* system. Shapiro-Wilk test was used to confirm normality of data. One-way ANOVA was used among the study groups followed by Tukey’s honestly significant difference (HSD) as a post hoc test (α = 0.05). All groups exhibited significant (p < 0.001) color change (ΔE > 0) after aging, with the control (0%) showing the highest ΔE. A progressive decrease in ΔE was observed with increasing bisoctrizole. Surface hardness was clinically comparable, though compared to the control, a statistically significant difference was found in Groups 1.5% and 2% (p < 0.001). Bisoctrizole had effectively preserved the color of scleral acrylic over time under UV light. Additionally, it had minimally affected the surface hardness of the material.

PMID:41951988 | DOI:10.1007/s44445-026-00166-8

Environ Monit Assess. 2026 Apr 9;198(5):422. doi: 10.1007/s10661-026-15294-1.

ABSTRACT

Heavy metal pollution in regional and global agricultural soils is an increasing concern, especially under the current context of frequent extreme climate events. In this study, we investigated the distribution characteristics of heavy metals in typical Chinese farmland soils under varying fertilization levels, precipitation intensities, and crop types. We employed a structural equation model (SEM) and random forest model (RFM) to elucidate the effects of precipitation, fertilizer application, soil properties, and other factors on the heavy metal content of farmland soils. Our findings demonstrated that level III fertilization posed the highest ecological risk of heavy metal contamination (ecological risk index (RI) = 219). Medium contamination risk was observed in areas with precipitation > 800 mm and precipitation of 400-800 mm (1 < pollution load index (PLI) ≤ 3). The RI (610) was 5.71 times higher in rice-wheat rotation areas than in areas with other crops. Geospatial, soil physicochemical properties, precipitation, and pesticides significantly impact heavy metal concentrations (p < 0.05). Furthermore, SEM and RFM have elucidated the distinct pathways through which diverse influencing factors affect soil heavy metal content, along with quantifying the magnitude of each contribution. Our results suggest that the escalation of precipitation (extreme and average precipitation) and the heightened intensity of human agricultural activities are exacerbating the deterioration of heavy metal contamination in agricultural soils. This research provides essential foundational data and significant references for the mitigation of heavy metal pollution in farmland soils.

PMID:41951982 | DOI:10.1007/s10661-026-15294-1

Support Care Cancer. 2026 Apr 9;34(5):413. doi: 10.1007/s00520-026-10643-9.

ABSTRACT

BACKGROUND: Cancer survivors often experience multidimensional functional limitations (FL) that can impact their overall health outcomes. This study primarily evaluated the associations of FL with all-cause and cancer-specific mortality, and secondarily with home care and emergency room use among US cancer survivors.

METHODS: Data from the 2004-2018 National Health Interview Survey (NHIS) were collected for this study. FL was defined as reporting difficulties in any of the 12 items across three dimensions: mobility, physical tasks and dexterity, and social and recreational engagement. The associations of FL with health outcomes were explored among 24,003 cancer survivors who were linked to the National Death Index (NDI) records through December 31, 2019. Multivariable Cox proportional hazard regression models, Fine and Gray regression models, and Logistic regression models were employed to estimate the associations between FL and all-cause mortality, cancer-specific mortality, home care, and emergency room use.

RESULTS: Cancer survivors reported significantly higher rates of FL compared to individuals without cancer across all FL items (all P < 0.001). FL was significantly associated with increased all-cause mortality (HR = 1.74, 95% CI = 1.59-1.91; P < 0.001), cancer-specific mortality (HR = 1.42, 95% CI = 1.27-1.58; P < 0.001), likelihood of requiring home care (OR = 4.05, 95% CI = 3.18-5.17; P < 0.001) and emergency room use (OR = 1.92, 95% CI = 1.75-2.11; P < 0.001). Similar results were found in the analyses for the three dimensions and the number of FL.

CONCLUSION: Three dimensions of FL were associated with increased mortality risk, home care, and emergency room use among cancer survivors. Targeted interventions to alleviate these limitations are essential for improving long-term outcomes.

PMID:41951973 | DOI:10.1007/s00520-026-10643-9

Nature. 2026 Apr;652(8109):379-386. doi: 10.1038/s41586-026-10260-w. Epub 2026 Apr 8.

ABSTRACT

Artificial light at night (ALAN) marks the global impact of humanity^1,2. Yet, our understanding of its true ebb and flow has been limited, often based on temporally aggregated satellite data that obscure finer dynamics. Here, using daily night-time satellite imagery³ and a continuous change detection approach^4,5, we created global maps of high-frequency ALAN dynamics (2014-2022). Our findings challenge the prevailing perspective that changes in light radiance are largely gradual and unidirectional. Instead, the nightlights of Earth are surprisingly dynamic, characterized by frequent and coexisting brightening and dimming. On average, each location experiencing change underwent 6.6 distinct shifts over the 9 years. Driven by this volatility, the cumulative area of total ALAN change comprised 2.05 million km² of abrupt changes and 19.04 million km² of gradual changes. Brightening contributed a radiance increase equivalent to 34% of the 2014 global baseline, whereas dimming offset this by 18%. Notably, both brightening and dimming have markedly intensified over the past decade. This evidence of increasing volatility in human night-time activity provides an important dynamic dimension for understanding urban evolution, energy transitions, policy impacts and ecological consequences of rapidly changing illuminated nights.

PMID:41951967 | DOI:10.1038/s41586-026-10260-w

Nature. 2026 Apr;652(8109):328-334. doi: 10.1038/s41586-026-10339-4. Epub 2026 Apr 8.

ABSTRACT

The outcomes of modern particle physics experiments, such as proton-proton collisions at the Large Hadron Collider at CERN (European Organization for Nuclear Research), depend crucially on the precise description of the scattering processes in terms of the fundamental forces. Among all the known forces that contribute, the limited understanding of the strong nuclear force is a key source of inaccuracy. At the fundamental level, the strong force is described by quantum chromodynamics, the theory of quarks and gluons. Their coupling, α_s, becomes weaker at high energies (asymptotic freedom), enabling power series expansions in α_s, but the confinement of quarks in hadronic bound states usually requires additional model assumptions. Consequently, determinations of α_s from experiment mostly remain with large systematic theory errors^1,2. Here we report the model-free determination of α_s with unprecedented precision from low-energy experimental input combined with large-scale numerical simulations of the first-principles formulation of quantum chromodynamics on a space-time lattice. The uncertainty, about half that of all other results combined³, originates predominantly from the statistical Monte Carlo evaluation and has a clear probabilistic interpretation. The result for α_s describes both low-energy hadronic physics with the help of lattice quantum chromodynamics and high-energy scattering using the perturbative expansion. By removing a source of theoretical uncertainty, our estimate of α_s could enable markedly improved analyses of many high-energy experiments⁴. This will contribute to the likelihood that small effects of yet unknown physics are uncovered, as well as enable stringent precision tests of the Standard Model.

PMID:41951966 | DOI:10.1038/s41586-026-10339-4

Nat Genet. 2026 Apr 8. doi: 10.1038/s41588-026-02554-6. Online ahead of print.

ABSTRACT

Genetic variants in RNU4-2, which is transcribed into the U4 small nuclear RNA component of the major spliceosome, were recently shown to cause ReNU syndrome, a prevalent dominant neurodevelopmental disorder (NDD). These variants almost exclusively arise de novo and cluster within 18 nucleotides of RNU4-2. Here we describe a new recessive NDD associated with homozygous and compound heterozygous variants in RNU4-2. We identify 38 individuals with biallelic variants outside the 18-nucleotide ReNU syndrome region that cluster within other functionally important elements of U4: Stem II, the k-turn and the Sm protein binding site. We characterize the clinical phenotype in 31 individuals, demonstrating that the recessive disorder is clinically distinct from ReNU syndrome and is associated with distinctive white matter abnormalities, including enlarged perivascular spaces. Finally, we find reduced RNU4-2 transcript levels in individuals with the recessive disorder, suggesting a loss-of-function disease mechanism that is distinct from the mechanism underlying ReNU syndrome. Together, these findings expand the genotypic and phenotypic spectrum of RNU4-2-associated NDDs.

PMID:41951959 | DOI:10.1038/s41588-026-02554-6

Aesthetic Plast Surg. 2026 Apr 8. doi: 10.1007/s00266-026-05811-5. Online ahead of print.

ABSTRACT

BACKGROUND: The inframammary fold (IMF) plays a central role in breast augmentation surgery, yet its long-term positional stability following implant placement remains insufficiently characterized. Accurate prediction of IMF location is essential for aesthetic outcomes, particularly when selecting surgical approaches or implant types.

METHODS: A retrospective observational study was conducted on 156 breasts (78 patients) who underwent augmentation between 2018 and 2022, with a minimum follow-up of 12 months. Pre- and postoperative measurements were obtained using 3D imaging in arm-adducted position. Variables included SN-Ni, Ni-Ni, Ni-IMF, SN-Nimid, Ni-IMFmid, and SN-IMFmid. Patients were stratified by implant shape (anatomic vs. round), placement plane (submuscular, subfascial, dual plane II), and incision type. Statistical analyses were performed to evaluate IMF displacement and associated factors.

RESULTS: The IMF was displaced by more than 10 mm from the planned position in 53.8% of cases. Anatomic implants demonstrated slightly less fold displacement than round implants (3 ± 14.7 mm vs. 8.1 ± 14 mm), although this was not statistically significant. Submuscular placement significantly increased lower pole expansion and IMF descent compared to subfascial placement (p < 0.05). There was no significant difference in fold stability based on incision type, including inframammary incisions where reinforcement sutures were used.

CONCLUSIONS: Caudal displacement of the IMF is common following breast augmentation. Submuscular placement contributes significantly to this effect. Anatomic implants may offer improved fold stability. Preoperative planning using the implant radius from the sternal midline is reliable. IMF reinforcement appears non-essential but warrants further study.

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:41951896 | DOI:10.1007/s00266-026-05811-5

EJNMMI Phys. 2026 Apr 9;13(1):32. doi: 10.1186/s40658-026-00844-w.

ABSTRACT

BACKGROUND: The digital cadmium-zinc-telluride (CZT)-based SPECT system offers good energy resolution. However, the impacts of dual-energy window scatter correction on image quality under narrower primary energy windows remain to be determined. This study aimed to assess the impacts of SC (with scatter correction) and NOSC (without scatter correction) on image quality under different primary energy windows.

METHODS: We used a standard NEMA/IEC 2007 phantom containing six hollow spheres of various sizes to simulate the human body at four target-to-background ratios (T/B ratio, the ratio of the average radioactive activity concentration in the target region to that in the background region, 32:1, 16:1, 8:1, and 4:1, respectively), by filling with ^99mTcO₄^–. For clinical validation, we recruited 20 patients and analyzed their whole-body bone scan images. Phantom and patient images were acquired with the Discovery NM/CT 670 CZT with list mode. Image quality of phantom was measured by calculating indicators from the NEMA NU 2-2018 standard, including percent background variability and percent contrast. Image quality of patients was measured by calculating coefficient of variation (COV), contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR). Visual quality was evaluated by two experts.

RESULTS: Higher percent background variability and COV values were present when SC was applied regardless of which energy window, acquisition time, or T/B ratio used, and statistically significant differences were observed between all SC and NOSC groups for both phantoms and patients. For phantoms, percent contrast values of most SC groups were higher than those of NOSC groups. For patients, CNRs and SNRs of SC groups were higher than those of NOSC groups (all P < 0.05). Visually, SC had higher visual scores than NOSC for both phantoms and patients.

CONCLUSIONS: SC significantly improves image contrast while minimizing concomitant image noise to a great extent and provides good visual image quality across different primary energy windows overall.

PMID:41951861 | DOI:10.1186/s40658-026-00844-w

Support Care Cancer. 2026 Apr 9;34(5):414. doi: 10.1007/s00520-026-10625-x.

ABSTRACT

PURPOSE: Hodgkin lymphoma survivors (HLSs) are at risk of developing late effects (LEs), and their knowledge is crucial for prevention and treatment. We explored HLSs’ knowledge and experience with LEs, their needs for information about LEs, lifestyle and rehabilitation, their needs for long-term follow-up, and factors associated with these needs.

METHODS: HLSs, treated from 1997 to 2006, aged < 49 years at diagnosis, were invited to this Norwegian cross-sectional questionnaire-based study performed in 2018/19. Medical records provided information on histology, stage, and treatment. Descriptive statistics and logistic regression analyses were employed.

RESULTS: In total, 304 responded (59% response rate), median age at diagnosis was 29 years (range 8-49), median age at survey was 46 (21-70), and 48% were females. Ninety percent had classical HL, 62% stage I-IIA disease, 94% received chemotherapy, and 77% radiotherapy. Thirty-two percent had experienced 1-2 LEs, and 40% ≥ 3 LEs. Information about lifestyle and/or rehabilitation was requested by 64%, and 58% wanted follow-up for LEs. In the multivariable analysis, lower education (OR 2.3, 95% CI 1.3-4.0), chronic fatigue (CF) (OR 2.3, 1.3-4.3), and physical inactivity (OR 2.1, 1.2-3.7) were associated with need for information on lifestyle and/or rehabilitation. CF (OR 2.4, 1.3-4.2) and received radiotherapy (OR 2.8, 1.5-5.3) were associated with the need for follow-up.

CONCLUSION: A high proportion of HLSs report LEs, and about 60% report a need for information and follow-up. Our findings contribute to the ongoing discussion on how to best organize cancer survivorship care. CF is associated with both information needs and follow-up, indicating that these survivors could benefit from a structured follow-up programme.

PMID:41951854 | DOI:10.1007/s00520-026-10625-x