Tag: statistics

Neuropeptides. 2026 Apr 3;117:102613. doi: 10.1016/j.npep.2026.102613. Online ahead of print.

ABSTRACT

Vascular dementia (VaD), primarily caused by chronic cerebral hypoperfusion (CCH), is characterized by progressive cognitive decline associated with neurovascular dysfunction. The present study aimed to investigate whether systemic administration of irisin, an exercise-induced myokine, modulates cognitive performance and VEGF-associated angiogenic signaling in the hippocampus under CCH conditions. Thirty-eight adult male Wistar albino rats were randomly assigned to five groups: control, sham, irisin, ischemia, and ischemia + irisin. CCH was induced via permanent bilateral common carotid artery occlusion. Irisin (100 ng/kg) was administered intraperitoneally three times per week for four weeks. Cognitive performance was assessed using the Morris Water Maze, and VEGF-positive vascular profiles were quantified within a standardized hippocampal area (1 mm² per section). CCH resulted in significant impairments in spatial learning and memory, accompanied by a reduction in VEGF-positive vascular profiles in the hippocampus. In healthy rats, irisin administration was associated with improved memory performance and increased VEGF-positive vascular profiles. In ischemic rats, irisin treatment was linked to partial improvements in memory parameters and VEGF-associated vascular changes, although these effects did not reach statistical significance. Learning-phase outcomes were more variable. Notably, the number of VEGF-positive vascular profiles positively correlated with spatial memory performance. These findings suggest that beyond its known neuroprotective properties, irisin may contribute to cognitive support through modulation of angiogenesis-associated signaling under CCH. While further studies are required to clarify optimal dosing strategies and mechanistic pathways, irisin may represent a promising adjunctive candidate for vascular cognitive impairment, particularly in individuals unable to engage in regular physical exercise.

PMID:41946010 | DOI:10.1016/j.npep.2026.102613

Cytokine. 2026 Apr 6;202:157144. doi: 10.1016/j.cyto.2026.157144. Online ahead of print.

ABSTRACT

BACKGROUND: The remodeling of the tumor immune microenvironment (TME) is a pivotal determinant of therapeutic efficacy and clinical outcome in Lung Adenocarcinoma (LUAD). While WNT signaling is a known oncogenic driver, the specific immunomodulatory role of WNT7A and its potential crosstalk with inflammatory pathways in LUAD remain to be fully elucidated. We sought to define the prognostic value of WNT7A and explore the molecular mechanisms by which it may foster an immunosuppressive TME.

METHODS: We performed a multi-omics analysis utilizing the TCGA-LUAD cohort (N = 508) and validated findings in an independent external cohort (GSE30219, N = 293). The prognostic significance of WNT7A was evaluated using Kaplan-Meier and multivariate Cox regression analyses. TME composition was dissected via ssGSEA, focusing on myeloid-derived suppressor cell (MDSC) infiltration. Mechanistic pathways were identified using Gene Set Enrichment Analysis (GSEA) and gene co-expression networks.

RESULTS: High WNT7A expression was identified as a significant predictor of poor Overall Survival (OS) in the TCGA cohort (P < 0.05) and validated in the external cohort (P < 0.05). Multivariate analysis confirmed WNT7A as an independent prognostic risk factor (HR = 1.085, P = 0.036). Immunologically, WNT7A expression was positively correlated with MDSC infiltration (R = 0.43, P < 0.001), suggesting a shift towards an immune-tolerant phenotype. Mechanistically, GSEA revealed a robust activation of inflammatory signaling in the high-WNT7A group. Specifically, the TNFA Signaling via NF-κB pathway was significantly enriched(NES = 2.52, P < 0.001). Consistent with this pathway activation, WNT7A showed a statistically significant positive correlation with CCL2 (P < 0.001), a critical chemokine for MDSC recruitment, implicating the NF-κB/CCL2 axis in this process.

CONCLUSION: WNT7A serves as a prognostic biomarker linked to immune evasion in LUAD, potentially by modulating the NF-κB/CCL2/MDSC axis. This study identifies WNT7A as a potential therapeutic target to remodel the immune microenvironment, providing a rationale for future investigations into WNT-targeted strategies to improve immunotherapy efficacy.

PMID:41946008 | DOI:10.1016/j.cyto.2026.157144

Early Hum Dev. 2026 Apr 4;219:106552. doi: 10.1016/j.earlhumdev.2026.106552. Online ahead of print.

ABSTRACT

BACKGROUND: This randomized controlled study examined the effect of the finger feeding method on stress and comfort behaviors in 72 preterm infants.

METHOD: Data were collected using the Neonatal Comfort Behavior Scale (NCBS) and the Neonatal Stress Scale (NSS). Infants in the intervention group received finger feeding until full oral feeding, while the control group was fed via orogastric tube.

RESULTS: In the intervention group, the mean NCBS score decreased from 19.75 ± 3.46 before the intervention to 13.42 ± 3.04 after the intervention, with a mean difference of 6.33 points. This decrease was statistically significant (F = 208.84, p < .05) and demonstrated a large effect size (partial η² = 0.856). In the control group, the mean NCBS score decreased from 22.69 ± 3.08 to 19.64 ± 4.04, with a mean difference of 3.05 points; although this reduction was statistically significant (F = 44.58, p < .05), the effect size was more limited compared to the intervention group (partial η² = 0.56). Regarding stress levels, the mean NSS score in the intervention group decreased significantly from 9.61 ± 2.96 to 0.97 ± 1.84, indicating a very large effect size (F = 670.21, partial η² = 0.85). In the control group, the mean NSS score decreased from 11.94 ± 3.02 to 7.42 ± 3.17; the effect size was more limited compared to the intervention group. The transition to full oral feeding was significantly faster in the intervention group (3.7 ± 0.1 days) compared to the control group (6.4 ± 0.6 days).

CONCLUSION: The finger feeding method was found to be an effective care practice for preterm infants, reducing stress levels, supporting comfort, facilitating a faster transition to full oral feeding, which may support the transition to breastfeeding, and can be adapted to nurse, parent, and family-centered care practices.

PMID:41945981 | DOI:10.1016/j.earlhumdev.2026.106552

Comput Methods Programs Biomed. 2026 Apr 2;281:109352. doi: 10.1016/j.cmpb.2026.109352. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Segmentation of brain vascular structures is a current challenge in radiology for the diagnosis of human vascular pathologies. Owing to the nature of cerebral vessels and to advances in supervised segmentation methods, the process of collecting a case set for segmentation with expert masks was very laborious and ambiguous. Objective analysis of automatic segmentation results remains a current, yet unaddressed challenge. To overcome these difficulties, a method for semi-automatic generating synthetic vessels within original computed tomography angiography images using expert masks was developed.

METHODS: Generating synthetic vessels that reflect real vessels enables an objective evaluation of segmentation methods and the geometric parameters of the vessels determined based on their segmentation. In this article, the results of four segmentation methods were examined based on generated vessels embedded in original images: UNETR, V-NET, nnUNET, and the classic Frangi method, which remains the baseline reference method. In addition, an analysis of selected geometric parameters of the segmented vessels was performed, including centerline distances, length, diameter, curvature and tortuosity.

RESULTS: This study investigated differences between the results of automatic segmentation of the selected arteries with reference to synthetic data. The obtained results indicate significant correlation between vessel geometric parameters and segmentation quality.

CONCLUSIONS: Even nnUNET, commonly considered the most effective vessel segmentation method, exhibits significant statistical differences in the determined vessel parameters. An objective analysis of the segmentation results and their geometric parameters, made possible by the developed vessel generation method, indicates a clear need for further development of vessel segmentation methods.

PMID:41945973 | DOI:10.1016/j.cmpb.2026.109352

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1543-1549. doi: 10.31557/APJCP.2026.27.4.1543.

ABSTRACT

BACKGROUND: One of the most prevalent oral cancers, oral squamous cell carcinoma (OSCC), is distinguished by its rapid growth, invasiveness, and high metastatic potential. Green AgNPs are important because they can reduce systemic toxicity by inducing oxidative stress, cytotoxicity, and apoptosis in cancer cells. The goal of this study was to use saponins as natural stabilizers to create AgNPs, and the detrimental apoptotic effects on cancer cells were examined using high-content screening (HCS) assays such as TNI, CMP, and VCC.

METHODS: The size and distribution of AgNPs were determined using saponins as natural reducing and stabilizing agents, respectively. The cytotoxic effects on OSCC-25 cells were assessed using the MTT assay, alongside real-time quantitative PCR (RT-qPCR) to identify changes in gene expression associated with apoptosis. High-content screening (HCS) was used to confirm the induction of apoptosis and to measure concentration-dependent changes in several cellular parameters. All statistical analyses were performed for each experiment.

RESULTS: The results showed that the average diameter of the generated nanoparticles was 75.87 ± 15.69 nm, facilitating cellular uptake due to their narrow size distribution. Saponin-induced AgNPs significantly increased cytotoxicity and cancer cell death in OSCC-25 cells in a dose-dependent manner. Compared with the control group, treatment with 125 and 500 μg/mL resulted in a significant decrease in fluorescence intensity (p < 0.05). However, doses of 250 μg/mL and 1000 μg/mL had no significant effects. RT-qPCR analysis revealed a significant increase in the expression of IL1R, highlighting its role in apoptotic signaling.

CONCLUSION: The findings suggest that the combination of the bioactive properties of saponins with the inherent cytotoxicity of AgNPs has therapeutic potential against oral squamous cell carcinoma. These results support the need for future preclinical and clinical studies and highlight the promise of integrating natural compounds with nanotechnology to develop safer and more effective anticancer therapies.

PMID:41945972 | DOI:10.31557/APJCP.2026.27.4.1543

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1535-1542. doi: 10.31557/APJCP.2026.27.4.1535.

ABSTRACT

BACKGROUND: Women with hemoglobinopathies represent a chronically ill population with frequent healthcare contact, yet limited integration into preventive health programs. Despite the proven effectiveness of HPV vaccination and screening, cervical cancer remains a preventable cause of both morbidity and mortality.

OBJECTIVE: To assess the levels of knowledge, awareness, and adherence to cervical cancer prevention and screening practices among women with hemoglobinopathies in Greece.

METHODS: A cross-sectional study was conducted among 202 women with thalassemia or sickle cell disease, attending a tertiary hospital’s Hemoglobinopathy Unit in Athens between December 2023 and March 2024. Data were collected using the validated Cervical Cancer Knowledge and Prevention Questionnaire (CCKP-64) and analyzed with SPSS 25, using descriptive and inferential statistics.

RESULTS: Nearly all participants were aware of cervical cancer (98.5%), the Pap test (99.0%), and the HPV vaccine (96.5%). However, only 6.5% were vaccinated against HPV, while 75.2% underwent annual Pap screening. Higher adherence to screening was associated with younger age (p = 0.009), employment status (p = 0.032), and higher income (p = 0.049). Knowledge regarding risk factors was moderate, with 58.4% recognizing HPV infection as the main cause. The most frequent reason for non-compliance was negligence (14.8%).

CONCLUSIONS: Despite adequate awareness of cervical cancer and good adherence to Pap testing, HPV vaccination rates remain strikingly low among women with hemoglobinopathies. This highlights missed opportunities to integrate HPV vaccination and education into chronic disease management. Tailored preventive strategies and continuous awareness campaigns are essential to achieving the WHO’s 2030 cervical cancer elimination goals.

PMID:41945971 | DOI:10.31557/APJCP.2026.27.4.1535

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1451-1458. doi: 10.31557/APJCP.2026.27.4.1451.

ABSTRACT

BACKGROUND: Stereotactic Body Radiotherapy (SBRT) is increasingly applied in the management of liver cancers. Flattening filter-free (FFF) beams, which offer higher dose rates, enable faster delivery and improved patient comfort. This retrospective study compares the dosimetric and delivery characteristics of SBRT using FFF and conventional flattened beams for the treatment of multiple liver targets.

METHODS: Twenty-six patients with 2-11 hepatic targets were treated using a single-isocenter volumetric modulated arc therapy (VMAT) technique. Treatment plans were created for 6X, 6FFF, and 10FFF photon beams, with prescription doses ranging from 27.5 Gy to 50 Gy in 5 fractions. Plan evaluation metrics included Planning Target Volume (PTV) coverage (V95%, V98%, V100%), mean liver dose (MLD), normal liver volume receiving <15 Gy, and maximum doses to Organs at Risk (OARs). Delivery parameters were assessed by gamma passing rate, monitor units (MU), and beam-on time (BOT). Repeated-measures ANOVA, with post-hoc least significant difference (LSD) testing, was used for statistical analysis.

RESULTS: Comparable Planning Target Volume (PTV) coverage was achieved with all beam modalities. No statistically significant differences were noted in mean liver dose (MLD), normal liver volume receiving <15 Gy, or other Organ at Risk (OAR) doses, except for lower spinal cord doses with FFF beams (p = 0.003). The 2%/2 mm gamma passing rate for 6FFF was 1% lower than for 6X and 10FFF. Monitor unit (MU) values were higher for 6FFF (4.3%) and 10FFF (1.5%) compared with 6X (p = 0.01). Beam-on time (BOT) was significantly shorter with 6FFF (3.8 ± 0.28 min) and 10FFF (3.8 ± 0.30 min) relative to 6X (5.1 ± 0.22 min) (p = 0.001).

CONCLUSION: Flattening filter-free (FFF) beams reduce beam-on time (BOT), providing an advantage for breath-hold techniques. However, despite the higher dose rate of 10FFF, no additional reduction in overall treatment time was observed.

PMID:41945962 | DOI:10.31557/APJCP.2026.27.4.1451

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1441-1450. doi: 10.31557/APJCP.2026.27.4.1441.

ABSTRACT

BACKGROUND: Breast cancer, the most common cancer among women in India, poses a significant public health challenge. However, data on pathways to care and out-of-pocket expenditure (OOPE) among breast cancer patients are limited in India. Kerala, despite its high literacy rates and excellent healthcare access, continues to experience significant delays in cancer care, making it an important setting for this study. Therefore, we aimed to study the pathways to care, estimate OOPE, and identify factors associated with OOPE among breast cancer patients in the Indian state of Kerala.

METHODS: We conducted a hospital-based cross-sectional study among 216 breast cancer patients (mean age: 57 years) from one private and one public tertiary cancer care centre (TCCC) in Kerala. A structured interview schedule was used to collect socio-demographic, clinical, and expenditure-related data. Descriptive statistics, Mann-Whitney U tests, and median regression analysis were performed. The duration of the study was from October 2024 to May 2025.

RESULTS: Most participants were diagnosed at early stages (n=152, 70.4%), and 42.5% (n=92) had health insurance coverage. In the study, 168 (77.8%: 95% CI: 71.6-83.1%) participants followed indirect pathways, initially consulting traditional healers (25, 11.57%) or other healthcare providers (143, 66.20%) before reaching TCCCs. OOPE was significantly higher among patients treated in private TCCCs compared to those in public TCCCs (median INR 2,26,395 vs 1,93,290; p = 0.015). Residence ≥82 km from the centre (coefficient:28470; p=0.044), treatment at private TCCC (coefficient:50010; p=0.001) and indirect pathway to TCCC (coefficient:46180; p=0.015) were significantly associated with higher OOPE.

CONCLUSION: The majority of breast cancer patients in Kerala accessed tertiary care through indirect pathways, with substantially higher out-of-pocket expenditure (OOPE) among those treated in private centres. Targeted policy interventions, such as strengthening primary care linkages and improving referral coordination, are essential to reduce delays in care pathways and alleviate the financial burden on breast cancer patients.

PMID:41945961 | DOI:10.31557/APJCP.2026.27.4.1441

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1411-1420. doi: 10.31557/APJCP.2026.27.4.1411.

ABSTRACT

OBJECTIVE: This article examines the financial impact of occupational cancer resulting from pesticide exposure and other carcinogenic agents in the floriculture sector of Cundinamarca, Colombia. It begins with a literature review covering (the) industry context, key occupational health factors, labor costs, and human capital. Based on this review, the study identifies gaps in the economic analysis of work-related illnesses such as cancer, particularly regarding hidden costs. Method: Using a quantitative explanatory approach, the research applies a multiple linear regression model to a dataset of 7,300 observations, analyzing absenteeism, labor costs, and worked days in relation to productivity.

RESULTS: The findings show a (59%) drop in productivity per diagnosed worker, leading to increased costs. The model yields an R² of (0.876), statistically supporting the hypothesis.

CONCLUSION: The study confirms the existence of hidden costs such as absenteeism, employee replacement, and medical expenses that are not reflected in financial statements.

PMID:41945958 | DOI:10.31557/APJCP.2026.27.4.1411

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1377-1388. doi: 10.31557/APJCP.2026.27.4.1377.

ABSTRACT

INTRODUCTION: Globally, hepatocellular carcinoma (HCC) ranks as the third most common cause of cancer-related death. The five-year overall survival (OS) rate for patients with unresectable HCC is only 12%. Currently, systemic therapies have become the primary treatment options for unresectable hepatocellular carcinoma. Studies comparing the efficacy of first-line treatments including lenvatinib, atezolizumab plus bevacizumab, and sorafenib have shown inconsistent results. There remains a need for updated comparative evidence on cross-mechanism therapy regimens for unresectable disease, as existing findings are still not completely clear. This network meta-analysis aims to provide clearer insights into which treatment offers greater efficacy for patients with unresectable HCC.

METHODS: This study was conducted following the 2022 PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Literature searches were performed using PubMed, ScienceDirect, Google Scholar, the Cochrane Library, SpringerLink, and EBSCO to gather studies comparing lenvatinib, atezolizumab plus bevacizumab, and sorafenib for the management of unresectable HCC. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Overall survival (OS) was analyzed using R statistical software (version 4.4.0).

RESULTS: Eleven studies reporting overall survival (OS) were included in the OS analysis comparing lenvatinib, atezolizumab plus bevacizumab, and sorafenib in the treatment of unresectable HCC. The network meta-analysis showed no significant OS differences between atezolizumab plus bevacizumab and lenvatinib (HR: 0.98; 95% CI: 0.24-4.10) or sorafenib (HR: 1.4; 95% CI: 0.21-9.87). Furthermore, there was no significant difference in OS between lenvatinib and sorafenib (HR: 1.41; 95% CI: 0.38-5.14). Based on the SUCRA plot in this meta-analysis, atezolizumab plus bevacizumab showed the highest probability of being ranked first among the three therapies. Lenvatinib had the highest probability of being ranked second, while sorafenib was more likely to be ranked third.

CONCLUSION: Atezolizumab plus bevacizumab, lenvatinib, and sorafenib demonstrated similar therapeutic efficacy based on overall survival. Although the hazard ratios (HRs) were not statistically significant, the SUCRA ranking suggested a clinical trend favoring atezolizumab plus bevacizumab.

PMID:41945955 | DOI:10.31557/APJCP.2026.27.4.1377