Tag: statistics

Front Oncol. 2026 Jun 26;16:1852055. doi: 10.3389/fonc.2026.1852055. eCollection 2026.

ABSTRACT

PURPOSE: To compare the effectiveness, safety, and tolerability of adjuvant trastuzumab plus pertuzumab (HP) versus trastuzumab emtansine (T-DM1) in patients with HER2-positive breast cancer with residual invasive disease after neoadjuvant therapy, and to perform exploratory analyses of outcomes in clinically favorable subgroups.

MATERIALS AND METHODS: Patients with HER2-positive breast cancer and residual invasive disease after NAT, enrolled between 2020 and 2024, were included. Propensity score matching (1:1) was applied to adjust for baseline characteristic differences. Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare survival outcomes (iDFS, RFS, OS) between the two groups. Additionally, the incidence of adverse events and treatment adherence were compared.

RESULTS: A total of 272 patients were analyzed, with 134 remaining after propensity score matching. After a median follow-up of 37.7 months, no statistically significant differences in short-term survival outcomes were detected between the two groups. Grade 3 or higher adverse events occurred more frequently in the T-DM1 group, particularly thrombocytopenia. Treatment interruption or regimen modification occurred in 22.7% of patients in the T-DM1 group and 2.2% in the HP group.

CONCLUSION: In HER2-positive breast cancer patients with residual invasive disease after NAT, no statistically significant difference in short-term recurrence or survival outcomes was detected between adjuvant HP and T-DM1, while HP was associated with a more favorable safety and tolerability profile. These findings should be interpreted as complementary real-world evidence in the contemporary dual-blockade era and as hypothesis-generating support for future risk-adapted adjuvant strategies.

PMID:42434737 | PMC:PMC13349879 | DOI:10.3389/fonc.2026.1852055

Front Ophthalmol (Lausanne). 2026 Jun 26;6:1830822. doi: 10.3389/fopht.2026.1830822. eCollection 2026.

ABSTRACT

BACKGROUND: Primary open-angle glaucoma (POAG) is the most common form of glaucoma and a leading cause of irreversible blindness worldwide. Treatment focuses on lowering intraocular pressure (IOP), often through cataract extraction with intraocular lens implantation (CE/IOL) alone or combined with minimally invasive glaucoma surgery (MIGS). However, comparative postoperative complication risks between these approaches remain unclear.

METHODS: This retrospective cohort study utilized the TriNetX US Collaborative Network to identify all adults (ages ≥18 years) with a diagnosis of POAG who underwent CE/IOL with or without concurrent MIGS between 2006 and 2026. The cumulative postoperative incidence of hyphema, cystoid macular edema (CME), retinal detachment (RD), and endophthalmitis were evaluated at four time intervals up to 90 days postoperatively. Propensity score matching was used to balance baseline characteristics and reduce confounding. Outcomes were compared using relative risks with 95% confidence intervals, and P-values were calculated using chi-square tests.

RESULTS: After propensity score matching, each routine cataract surgery cohort (with and without MIGS) comprised 7, 998 patients. Patients undergoing CE/IOL with MIGS had a significantly higher rate of hyphema compared with patients undergoing CE/IOL alone at all reported postoperative time points, with a cumulative incidence of 1.19% versus 0.15% at 1-90 days after surgery, respectively (P<0.0001). Conversely, the cumulative incidence of CME (2.585% vs 2.376%, P = 0.3993), RD (0.215% vs 0.139%, P = 0.2566) and endophthalmitis (0.276% vs 0.15%, P = 0.0862) at 1-90 days postoperatively at 1-90 days postoperatively were not statistically different between groups. Similar associations were observed among patients undergoing routine or complex CE/IOL combined with MIGS compared with those undergoing routine or complex CE/IOL alone with respect to hyphema, CME, and RD.

CONCLUSIONS: In this large retrospective cohort study, combined CE/IOL with MIGS was associated with a significantly increased risk of postoperative hyphema, while rates of CME, RD, and endophthalmitis remained comparable to CE/IOL alone.

PMID:42434709 | PMC:PMC13349877 | DOI:10.3389/fopht.2026.1830822

Front Ophthalmol (Lausanne). 2026 Jun 26;6:1776570. doi: 10.3389/fopht.2026.1776570. eCollection 2026.

ABSTRACT

PURPOSE: This study aimed to investigate how age affects the genetic and clinical characteristics of retinitis pigmentosa (RP), focusing on the detectability of causative genes and the age at disease onset.

METHODS: We conducted a single-center study of 506 patients with RP who underwent comprehensive genetic testing through targeted resequencing of 83 known RP-associated genes using next-generation sequencing. Patients were stratified by age at study entry into six groups: <40 years (20-39), 40s (40-49), 50s (50-59), 60s (60-69), 70s (70-79), and ≥80 years. Detection rates of causative genes were calculated and compared across age groups using the Cochran-Armitage trend test. Genetically solved cases included 42 with EYS, 19 with USH2A, 9 with RP1, 14 with RHO, and 7 with RPGR. Clinical data were collected retrospectively. Age at onset was defined as the age when the patient first noticed night blindness, visual field constriction, or decreased best corrected visual acuity. Age at onset was compared across causative genes using an one-way analysis of variance (ANOVA). For pairwise comparisons, the Wilcoxon rank-sum test was applied with Bonferroni correction to adjust for multiple testing.

RESULTS: The mean age of participants was 58.8 years, and our sample included 235 males and 271 females. Case numbers by age group were as follows: <40 years, 58; 40s, 92; 50s, 94; 60s, 125; 70s, 104; and ≥80 years, 33. Detection rates of causative genes declined steadily with age: 39.7% (<40), 41.3% (40s), 36.2% (50s), 27.2% (60s), 19.2% (70s), and 3.0% (≥80), showing a statistically significant trend (p = 8.22 × 10^-7, Cochran-Armitage trend test). In subset analysis, mean onset ages were RPGR (5.2 years), EYS (19.5 years), RHO (24.3 years), RP1 (25.2 years), and USH2A (34.1 years), indicating a significant difference among genes (p < 0.001). Pairwise comparisons showed significantly earlier onset in the RPGR group relative to USH2A (p = 0.004).

CONCLUSIONS: The detection rate of known causative genes of RP was lower in the elderly patients, potentially reflecting factors associated with a late-onset phenotype.

PMID:42434706 | PMC:PMC13349749 | DOI:10.3389/fopht.2026.1776570

Med Image Comput Comput Assist Interv. 2026;15963:661-671. doi: 10.1007/978-3-032-04965-0_62. Epub 2025 Sep 19.

ABSTRACT

Optical coherence tomography (OCT) images are often acquired as highly anisotropic volumes, where the scanning step is dense along the fast axis but sparse along the slow axis. This affects image analysis, such as image registration for longitudinal alignment. To create more isotropic volumes, bicubic interpolation can be used along the slow axis, but it generally produces blurry features. Registration-based interpolation can reduce blurriness, but often fails to generate realistic OCT images. Deep generative models can sample realistic images, but lack the structural consistency constraints required for interpolation. In this paper, we propose an unsupervised image interpolation method that combines registration-based interpolation with a deep generative model to overcome their individual limitations and improve the structural accuracy and realism of interpolated OCT images. We compare the proposed method with both bicubic and registration-based interpolation on real OCT datasets, and show that it achieves the best interpolation performance.

PMID:42434689 | PMC:PMC13352931 | DOI:10.1007/978-3-032-04965-0_62

Front Behav Neurosci. 2026 Jun 19;20:1861841. doi: 10.3389/fnbeh.2026.1861841. eCollection 2026.

ABSTRACT

BACKGROUND: Aging is associated with progressive alterations in behavioral function, yet majority of the studies interpret behavioral outcomes on an assay-by-assay basis, limiting understanding of how behavioral domains are organized. Our previously published study used a mouse cohort to report assay-specific behavioral effects. In this study, we examined whether aging-related behavioral signals remain localized to individual assays or can be summarized as coordinated domain-level patterns.

METHODS: A structured rule-based workflow was implemented for feature engineering, direction harmonization, z-score standardization, and domain-level composite construction across locomotion/exploration, anxiety/avoidance, depression/passive coping, cognition/learning, memory, and sociability domains. Outcomes were analyzed using parametric or non-parametric models following assumption screening, with effect sizes reported.

RESULTS: Domain-level composite scores did not show significant age- or sex-related effects, indicating limited broad behavioral separation. In contrast, refined feature-level analysis identified modest locomotor differences (core locomotion distance; Kruskal-Wallis p = 0.048) and the clearest age-related signal in Barnes Maze performance, particularly the Barnes Maze efficiency index (F = 10.815, p < 0.001), with reduced performance in older animals. Repeated-measures analyses further confirmed training-related improvements in latency across days. Several additional measures showed a trend but did not reach statistical significance and hence are reported descriptively only.

CONCLUSION: Aging-related behavioral changes in this dataset were concentrated in specific assay-level measures rather than broadly distributed across domains. Domain-level aggregation reduced separation of effects, indicating that the present composites should be interpreted as heuristic summaries rather than validated behavioral dimensions. The main added value of this reanalysis is therefore interpretive, showing that the strongest signals remain most evident in selected measures, particularly Barnes Maze outcomes.

PMID:42434686 | PMC:PMC13351101 | DOI:10.3389/fnbeh.2026.1861841

Cureus. 2026 Jun 9;18(6):e110557. doi: 10.7759/cureus.110557. eCollection 2026 Jun.

ABSTRACT

BACKGROUND AND OBJECTIVE: The rising prevalence of opioid use during pregnancy has contributed to increasing rates of neonatal opioid withdrawal syndrome (NOWS). Traditional management using the Finnegan Neonatal Abstinence Scoring System (FNASS) is associated with prolonged hospitalization, increased neonatal intensive care unit (NICU) utilization, and reduced maternal‑infant bonding. Function‑based models such as Eat, Sleep, Console (ESC) emphasize non‑pharmacologic care and may improve outcomes. This project aimed to transition from FNASS to ESC within a small safety‑net hospital and evaluate associated clinical outcomes.

METHODS: We conducted a single‑center quality improvement initiative using a phased implementation strategy over 2.5 years. Eligible neonates were >36 weeks gestation or >2000 grams with prenatal opioid exposure. Clinical outcomes were compared between infants managed with FNASS (n=24) and ESC (n=12). Due to the small sample size and skewed distributions, continuous variables were analyzed using Mann-Whitney U tests and reported as medians with interquartile ranges.

RESULTS: ESC implementation was associated with shorter median length of stay (3.5 vs. 16.5 days; p<0.001), fewer days on pharmacologic treatment (0 vs. 11.5 days; p=0.008), and fewer days in the NICU (0 vs. 13.5 days; p<0.001). Infants in the ESC group spent a higher percentage of hospitalization bonding with their mothers (100% vs. 14.6%; p=0.002), although the total number of bonding days did not differ significantly (p=0.199). Pharmacologic treatment use was lower in the ESC group (0% vs. 54.2%; p=0.002).

CONCLUSIONS: Transitioning to ESC was associated with reduced pharmacologic treatment, shorter hospitalization, decreased NICU utilization, and improved maternal‑infant bonding. These findings support the feasibility of ESC implementation in resource‑limited safety‑net settings and highlight a scalable framework for equitable NOWS care.

PMID:42434680 | PMC:PMC13349960 | DOI:10.7759/cureus.110557

Cureus. 2026 Jun 10;18(6):e110582. doi: 10.7759/cureus.110582. eCollection 2026 Jun.

ABSTRACT

Introduction Menstrual cups are a safe, cost-effective, and sustainable menstrual hygiene product; however, their awareness and acceptability among adolescents remain low due to socio-cultural barriers and misconceptions. The study aimed to assess the knowledge, awareness, myths, and acceptability of menstrual cups among adolescent girls and to evaluate factors influencing their willingness to use them. Materials and methods A community-based cross-sectional study was conducted among 812 adolescent girls aged 13-19 years in Nagamangala taluk, Karnataka, from February to April 2026. Data were collected using a pre-tested semi-structured questionnaire. Knowledge was categorized as adequate when >50% responses were correct. Associations were analyzed using the chi-squared test, with p < 0.05 considered statistically significant. Results Awareness of menstrual cups was observed in 308 (37.9%) participants. Adequate knowledge was present in 342 (42.1%), while myths and misconceptions were reported by 498 (61.3%). The most common misconception was fear of pain during insertion 362 (44.6%). Overall, 548 (67.5%) participants expressed willingness to use menstrual cups. Awareness increased significantly with age (χ² = 9.82, p = 0.002). Willingness was significantly higher among those aware, 220 (71.4%), compared to those not aware, 328 (65.1%) (χ² = 4.21, p = 0.040). Adequate knowledge was associated with higher acceptability (χ² = 14.7, p < 0.001), while the presence of myths was associated with lower willingness (χ² = 41.6, p < 0.001). Conclusion Despite low awareness and prevalent misconceptions, the acceptability of menstrual cups was relatively high, particularly after exposure to appropriate information. Strengthening menstrual health education and addressing myths may improve the adoption of menstrual cups among adolescents.

PMID:42434676 | PMC:PMC13352334 | DOI:10.7759/cureus.110582

Cureus. 2026 Jun 10;18(6):e110620. doi: 10.7759/cureus.110620. eCollection 2026 Jun.

ABSTRACT

Deglutition disorders and cognitive impairment co-occur frequently in older adults and in patients with neurodegenerative or cerebrovascular disease, yet the intellectual structure and collaborative patterns at this clinical interface have not been mapped. We performed a bibliometric analysis, with scoping-review-style charting, of publications indexed in the Scopus database through the search date of 10 October 2025; we retrieved 1,190 records and retained the 100 most-cited articles for in-depth analysis. Because the most recent publications (2023-2025) have not yet accrued sufficient citations, the resulting top-100 corpus spans 2009-2022. Articles were stratified into three citation tiers: Hyperclassics (≥500 citations, n = 11), Top-Class (250-499 citations, n = 20), and Classics (100-249 citations, n = 69). Performance analysis and science mapping were conducted in R version 4.4.2 (R Foundation for Statistical Computing, Vienna, Austria) using the bibliometrix and biblioshiny packages (open-source; https://www.bibliometrix.org/). Continuous variables were compared using the Kruskal-Wallis test followed by post hoc Mann-Whitney U tests; categorical variables with the chi-squared test and Cramér’s V; and correlations among journal indicators with Spearman’s rho and 95% confidence intervals derived via Fisher’s z-transformation. The corpus accumulated 30,872 total citations (range 112-4,312). Stroke was the leading venue (6 articles; 7,909 citations; 25.6% of the corpus), and the United States contributed 32 articles representing 47% of all citations, followed by the United Kingdom, Italy, Canada, and Germany. Hyperclassics significantly out-cited Classics in both total citations and citations per year (both p<0.0001) but not in author count or active years. Inter-metric correlations among Journal Impact Factor (JIF), CiteScore, SCImago Journal Rank (SJR), and Source Normalized Impact per Paper (SNIP) were uniformly strong (ρ>+0.84; all p<0.001), whereas correlations between these journal-level indicators and article-level citations were weak (ρ +0.22 to +0.29; all p<0.05). Keyword co-occurrence resolved three thematic clusters-stroke, dementia, and dysphagia (clinical burden and nutrition); Parkinson’s disease and movement disorders; and neurological symptoms, cognition, and diagnostic imaging-while a complementary thematic-evolution analysis traced eight finer research streams. The field is dominated by stroke-related research and Anglo-American academic medicine, with a small set of influential guidelines driving disproportionate citation weight. Within this most-cited corpus, articles centred explicitly on the dysphagia-cognition interface were comparatively few (14% of the corpus), whereas disease-context and guideline records predominated; sensitivity analyses excluding peripheral records preserved the thematic and geographic structure. Estimating under-representation relative to clinical burden would require a field-normalised denominator and is proposed as future work. Future work should prioritize mechanistic neuroimaging in cognitively impaired patients, validated screening instruments adapted for dementia and parkinsonism, and comparative-effectiveness trials of dysphagia interventions across diagnostic categories.

PMID:42434674 | PMC:PMC13354282 | DOI:10.7759/cureus.110620

Cureus. 2026 Jun 9;18(6):e110560. doi: 10.7759/cureus.110560. eCollection 2026 Jun.

ABSTRACT

Introduction Effective labor analgesia plays a crucial role in improving maternal comfort and the overall childbirth experience. The aim of the present study was to compare maternal satisfaction and breakthrough pain between programmed intermittent epidural bolus (PIEB) and continuous epidural infusion (CEI) techniques for labor analgesia. Materials and methods This cross-sectional study was conducted in the Department of Anesthesiology among 192 term pregnant women who received epidural labor analgesia. The participants were equally divided into PIEB (n = 96) and CEI (n = 96) groups according to the maintenance epidural regimen received during labor. Maternal satisfaction was assessed using a 0-10 numeric rating scale. Secondary outcomes included breakthrough pain, physician-administered rescue boluses, patient-controlled epidural analgesia (PCEA) utilization, analgesic consumption, adverse events, and willingness to repeat the same analgesic technique. Statistical analysis was performed with p < 0.05 considered statistically significant. Results Maternal satisfaction scores were significantly higher in the PIEB group than in the CEI group (8.6 ± 0.9 vs. 7.9 ± 1.2; p = 0.001). High satisfaction (score ≥8) was observed in 72 (75.0%) participants in the PIEB group compared with 56 (58.3%) in the CEI group. Breakthrough pain occurred less frequently in the PIEB group than in the CEI group (p = 0.011). The number of physician-administered top-up boluses and PCEA activation was significantly lower in the PIEB group. Total local anesthetic volume and fentanyl consumption were also significantly reduced in the PIEB group (p < 0.05). Adverse maternal events were low and comparable between the groups. Conclusions PIEB provided superior maternal satisfaction and improved analgesic efficacy with lower anesthetic consumption than CEI while maintaining a comparable safety profile. These findings support the use of PIEB as an effective maintenance strategy for epidural analgesia during labor.

PMID:42434670 | PMC:PMC13350300 | DOI:10.7759/cureus.110560

Cureus. 2026 Jun 9;18(6):e110554. doi: 10.7759/cureus.110554. eCollection 2026 Jun.

ABSTRACT

Lumbar radiculopathy is a prevalent and debilitating spinal condition that causes severe pain, functional impairment, and diminished quality of life. Although conservative treatments are widely recommended as first-line management, establishing their comparative effectiveness remains challenging due to substantial heterogeneity in the literature. This systematic review synthesized and critically appraised the evidence evaluating non-surgical, conservative interventions for lumbar radiculopathy. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, this review was prospectively registered with PROSPERO (CRD420261407070). Comprehensive electronic searches were conducted across PubMed, Scopus, Web of Science, Embase, and the Cochrane Library up to 2026. Randomized controlled trials (RCTs) involving participants with clinically or radiologically confirmed lumbar radiculopathy were eligible for inclusion. Methodological quality was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool. Due to marked clinical and methodological heterogeneity, a quantitative meta-analysis was precluded, and a structured narrative synthesis was performed instead. Nineteen RCTs published between 2016 and 2026 met the inclusion criteria. The investigated therapies included manual therapy, neural mobilization, exercise rehabilitation, physical modalities, and multimodal regimens. Rather than purely qualitative benefits, individual trials demonstrated quantifiable short-term improvements. Manual therapy combined with exercise or neurodynamics yielded significant advantages over conventional care; for instance, adding spinal mobilization with leg movement (SMWLM) achieved a mean difference (MD) in leg pain reduction of 2.0 (95% CI: 1.4 to 2.6) at two weeks and 2.6 (95% CI: 1.9 to 3.2) at six months. Similarly, targeted neural mobilization outperformed traditional therapy at eight weeks (pain MD: -2.4, 95% CI: -3.1 to -1.7; disability MD: -12.8%, 95% CI: -16.1% to -9.5%). Traditional Persian manual therapy combined with exercise reduced low back pain by 4.28 units (95% CI: 3.36 to 5.19). However, clinical superiority was inconsistent across all outcome domains, long-term follow-ups were rare, and conservative treatment non-response or failure remained a distinct clinical possibility. Methodological limitations, including a high risk of bias regarding incomplete blinding of participants/therapists and selective outcome reporting, were frequently observed across multiple trials. Conservative interventions yield measurable, statistically significant short-term improvements in pain and function for lumbar radiculopathy. However, the overall certainty of the evidence is limited by high clinical heterogeneity and trial-level methodological constraints, which precluded data pooling. Findings should be interpreted cautiously, and further high-quality trials with standardized outcomes and adverse event reporting are required.

PMID:42434659 | PMC:PMC13349735 | DOI:10.7759/cureus.110554