Tag: statistics

J Cancer Allied Spec. 2026 Mar 12;11(1):51-61. doi: 10.2478/jcas-2025-0009. eCollection 2025 Jan.

ABSTRACT

INTRODUCTION: Chromophobe renal cell carcinoma (CHRCC) is the third most common RCC subtype, typically with a favorable prognosis, though some cases show aggressive behavior. The prognostic utility of tumor grading in CHRCC remains controversial, particularly regarding the Fuhrman grading system due to inherent nuclear atypia. The Paner et al. three-tiered chromophobe tumor grading (CTG) system addresses these limitations by incorporating nuclear crowding and anaplasia. This study evaluates CTG’s prognostic value versus Fuhrman grading and other factors like pT stage, sarcomatoid differentiation, and tumor necrosis.

MATERIALS AND METHODS: This retrospective study analyzed 51 patients who underwent radical nephrectomy for chromophobe renal cell carcinoma (CHRCC) at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, between 2014 and 2019. Tumors were graded using the Fuhrman and Paner CTG systems. Prognostic factors assessed included pT stage, sarcomatoid differentiation, and tumor necrosis. Statistical analysis used Chi-square and independent sample T-tests. Survival analysis was performed using Kaplan-Meier curves to determine overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS).

RESULTS: Most cases (68.6%) were CTG grade 1-2, and 31.4% were grade 3. All adverse events occurred in grade 3 tumors (DMFS 75%, RFS 93.8%, CSS 87.5%). Grades 1-2 had 100% survival. Fuhrman grading showed less prognostic relevance due to inconsistent results. Tumor necrosis and advanced pT stage correlated with poor outcomes. Sarcomatoid differentiation appeared in one of four progressing cases.

CONCLUSION: The Paner CTG system effectively stratifies CHRCC patients by prognostic risk. It outperforms Fuhrman grading in predicting adverse outcomes. Higher tumor grade, necrosis, and advanced pT stage all significantly correlated with poor prognosis. These findings support adopting the Paner grading system for CHRCC to improve risk stratification and clinical decisions. Larger studies are warranted to validate these results.

PMID:41841143 | PMC:PMC12989086 | DOI:10.2478/jcas-2025-0009

F1000Res. 2026 Mar 5;11:206. doi: 10.12688/f1000research.79534.2. eCollection 2022.

ABSTRACT

INTRODUCTION: Social distancing and wearing a face mask are highly recommended to mitigate the transmission of coronavirus disease 2019 (COVID-19). However, the success of these strategies relies on individuals’ adherence and public compliance. This study was conducted to assess the level of belief in social distancing and face mask practices in communities in low- and middle-income countries (LMICs) and to identify their possible determinants.

METHODS: A cross-sectional study was conducted in ten LMICs countries in Asia, Africa, and South America from February to May 2021. A questionnaire was used to assess the belief, practice, and their plausible determinants. Identification of the associated determinants was performed using a logistic regression model.

RESULTS: Our data revealed that only 62.6% and 66.9% of the participants had good beliefs in social distancing and good face mask practices, respectively. Residing in the Americas, having a healthcare-related job, knowing people in immediate social environment who are or have been infected and exposure to information of COVID-19 cases on social media or TV were factors significantly associated with good belief in social distancing. Residing country, gender, monthly household income, type of job and exposure to information of COVID-19 cases were significantly associated with face mask wearing practice.

CONCLUSION: The proportion of participants having good beliefs in social distancing and good face mask practices is relatively low (<75%). Hence, sustained health campaigns regarding social distancing benefits and face mask-wearing practices during COVID-19 are critical in LMICs.

PMID:41841141 | PMC:PMC12989056 | DOI:10.12688/f1000research.79534.2

Bioinform Adv. 2026 Feb 18;6(1):vbag061. doi: 10.1093/bioadv/vbag061. eCollection 2026.

ABSTRACT

MOTIVATION: Systemic lupus erythematosus patients exhibit a broad clinical spectrum of manifestations and suffer from high rates of treatment failure. These can be attributed to disease heterogeneity due to differentially dysregulated pathways. Precision medicine considering the individualized molecular disease driving mechanisms is a promising strategy to address challenges imposed by disease heterogeneity. Available patient blood transcriptome data coupled with pathway-based single-sample scoring approaches have been extensively employed to reveal molecular footprints of disease states and progression as well as delineate population heterogeneity. However, systemic understanding of pathways involved in disease pathogenesis remains lacking.

RESULTS: We created a SLE-diseaseome, an integrative multi-cohort collection of disease-relevant functional gene sets. This resource contains a comprehensive collection of disease-specific gene signatures combining knowledge from several pathway databases and signature sources robustly defined by integrating multiple studies. It offers reliable and extensive reference signatures in a disease-specific manner for functional interpretation of molecular data from clinical studies.

AVAILABILITY AND IMPLEMENTATION: The code used to run the pipeline and the R object containing the SLE-diseaseome collection are available at https://github.com/dtordom/SLEDiseaseome.

PMID:41841101 | PMC:PMC12989159 | DOI:10.1093/bioadv/vbag061

Cureus. 2026 Feb 13;18(2):e103529. doi: 10.7759/cureus.103529. eCollection 2026 Feb.

ABSTRACT

Background Erectile dysfunction (ED) is considered a condition commonly affecting men, particularly those over 40 years old, with a significant impact on quality of life. Phosphodiesterase-5 (PDE-5) inhibitors, including Avanafil and Tadalafil, are widely used for the treatment of ED. However, there is limited comparative data on their safety and efficacy. Objective This study aims to evaluate the safety and efficacy of Avanafil compared to Tadalafil when administered on-demand in patients with ED. Methods This prospective observational study was conducted over one year in a tertiary care hospital in India. A total of 106 patients with ED were enrolled and divided into two groups based on the medication prescribed by the treating physician: Group A received Avanafil (100 mg), and Group B received Tadalafil (10 mg). The key primary objective was to measure the change in the International Index of Erectile Function – Erectile Function (IIEF-EF) domain scores at 4, 8, and 12 weeks. Secondary outcomes included changes in other IIEF domains, Sexual Encounter Profile (SEP) scores, and partner satisfaction. Adverse events were recorded to assess safety. Results Both Avanafil and Tadalafil significantly improved IIEF-EF scores from baseline. Tadalafil showed superior efficacy, with statistically significant improvements in IIEF-EF scores at 4 weeks (p = 0.008), 8 weeks (p < 0.01), and 12 weeks (p < 0.01) compared to Avanafil. There were no significant differences between the two groups in terms of orgasmic function, sexual desire, intercourse satisfaction, or overall satisfaction. SEP profiles were similar between the groups throughout the study. Adverse effects were mild and comparable between the groups, with no significant differences in the overall incidence of side effects. Conclusion Tadalafil demonstrated slightly better efficacy in improving erectile function compared to Avanafil, although both drugs were effective and well-tolerated. The choice of treatment should consider patient preferences and specific clinical contexts, as both medications offer significant benefits with minimal risk of severe adverse effects. Both PDE-5 inhibitors were effective based on patient-reported outcomes, although objective rigidity was not measured.

PMID:41841099 | PMC:PMC12989142 | DOI:10.7759/cureus.103529

Cureus. 2026 Feb 12;18(2):e103514. doi: 10.7759/cureus.103514. eCollection 2026 Feb.

ABSTRACT

Introduction Breast cancer remains one of the leading causes of cancer-related mortality among women in India. Early detection and prevention are crucial, and medical students play a vital role in promoting awareness. Objective This study assessed how well undergraduate medical students in North India understand breast cancer symptoms, risk factors, screening, and treatment. Methods A cross-sectional study using a 30-item, semi-structured, self-developed questionnaire was distributed through Google Forms. The questions covered general awareness; biological, reproductive, and lifestyle risk factors; as well as screening practices. Students from different MBBS academic years participated. Responses were analyzed using GraphPad Prism 8.0.2, applying descriptive statistics and chi-square tests to identify associations, with significance set at p < 0.05. Results A total of 307 students responded, nearly two-thirds of whom were female. The most recognized key risk factors were family history (94.1%), smoking and alcohol consumption (86.3%), and childhood radiation exposure (87.3%). Awareness of biological risks such as early menstruation (71.7%) and late menopause (67.4%) was moderate. However, knowledge about reproductive risks was weaker: only 58% recognized nulliparity, 59% were aware of hormone replacement therapy as a risk factor, and 55% identified late first childbirth. Screening knowledge showed similar gaps. While 87% had heard of breast self-examination (BSE), only one-third knew the correct timing. Less than half were aware that mammography is advised in the 40s and 50s, and only 66% realized that breast cancer can occur without pain or a lump. Conclusion Undergraduate medical students in North India demonstrated moderate awareness of breast cancer, with notable gaps in understanding lifestyle-related risk factors and screening methods. Strengthening medical curricula and integrating breast cancer awareness programs are essential to enhance students’ knowledge and their future role in community health promotion.

PMID:41841097 | PMC:PMC12989060 | DOI:10.7759/cureus.103514

Cureus. 2026 Feb 13;18(2):e103532. doi: 10.7759/cureus.103532. eCollection 2026 Feb.

ABSTRACT

Background HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets) is a severe obstetric complication associated with significant maternal morbidity and mortality. While its epidemiology is well-described in high-resource settings, data from conflict-affected and resource-limited regions like Afghanistan are critically scarce. This study aimed to delineate the incidence, risk profiles, complications, and outcomes of HELLP syndrome at a major tertiary healthcare hospital. Methodology A retrospective, descriptive case series was conducted at Rabia Balkhi Hospital in Kabul, reviewing all obstetric admissions from January 1 to December 31, 2022. Among 29,633 admissions, 26 patients met the inclusion criteria for HELLP syndrome based on established laboratory parameters (LDH >600 U/L, AST >70 U/L, platelets <100,000/mm³). Data on demographics, clinical presentation, risk factors, complications, and maternal outcomes were extracted and analyzed using descriptive statistics. Results The incidence of HELLP syndrome was 26 cases (0.09%) of all obstetric admissions. The most prevalent risk factors were abruptio placentae (10, 38.5%), diabetes mellitus (5, 19.2%), and chronic hypertension (4, 15.4%). Major maternal complications included disseminated intravascular coagulation (5, 19.2%), renal failure (4, 15.4%), and pulmonary edema (3, 11.5%). Notably, subcapsular liver hematoma, a rare but often fatal complication, was present in two cases (7.7%). The maternal mortality rate was 7.7% (n = 2), with a 92.3% recovery rate among survivors. Conclusions This study provides the first detailed epidemiological profile of HELLP syndrome. While the incidence aligns with some regional reports, the high prevalence of severe complications and a substantially elevated maternal mortality rate highlight critical systemic challenges. These findings underscore the urgent need for enhanced antenatal screening, early diagnosis, and improved access to critical care resources, including platelet transfusions and emergency surgical intervention, to mitigate preventable deaths in low-resource settings.

PMID:41841095 | PMC:PMC12989169 | DOI:10.7759/cureus.103532

Cureus. 2026 Feb 13;18(2):e103547. doi: 10.7759/cureus.103547. eCollection 2026 Feb.

ABSTRACT

Background and objective First-line tissue sampling for prostate cancer can be performed using either transrectal ultrasound biopsy (TRUS) or local anaesthetic transperineal biopsy (LATP). The aim of this study is to compare these two techniques, examining outcomes of procedure tolerability, complications and cancer detection rate. Methods A retrospective, single-centre cohort study of patients undergoing prostate biopsy was performed. A telephone questionnaire was completed 72 hours post-biopsy, focusing on pain scores and complications. Cancer detection rates were also recorded. Results This study included 110 patients (55 LATP, 55 TRUS). Clinical data examining age, digital rectal examination findings, prostate-specific antigen (PSA), PSA density, prostate volume and prostate imaging reporting and data system (PI-RADS) score were gathered. Tolerability in both LATP and TRUS was similar. The median pain score on ultrasound probe use and biopsy gun deployment was marginally higher in the TRUS group. Difficulty passing urine occurred in 9% of LATP and 16% of TRUS (p=0.3916). Haematuria was seen in 58% of LATP and 73% of TRUS (p=0.1600). No patient required hospital admission. Cancer detection rates for LATP versus TRUS were 58.2% and 47.3%, respectively, (p = 0.3397) with higher LATP detection also seen in isolated PI-RADS 4/5 cases (p=0.2270). No statistically significant difference was found in detection rates or complications. Conclusion LATP is safe when compared to TRUS in all aspects of procedure tolerability, complications, and cancer detection rate.

PMID:41841093 | PMC:PMC12989238 | DOI:10.7759/cureus.103547

Cureus. 2026 Feb 13;18(2):e103548. doi: 10.7759/cureus.103548. eCollection 2026 Feb.

ABSTRACT

Background Intravascular lithotripsy (IVL) is increasingly used to treat heavily calcified lower-limb arterial disease. We audited outcomes from a UK vascular center to assess the safety and effectiveness of this modality. Methods This was a single-center prospective audit of consecutive patients undergoing IVL at a UK vascular center between March 2023 and September 2025. Demographic data, lesion characteristics (including peripheral artery calcification scoring system {PACSS} grade), procedural details, and outcomes were recorded. Primary outcomes assessed safety, measured by 30-day survival, 30-day amputation-free survival (AFS), and procedure-related complications (perforation, dissection, and distal embolization), and effectiveness, defined as target vessel recanalization. Secondary outcomes included 30-day hospital readmission and one-year AFS. Statistical analyses included Fisher’s exact test and t-tests, as appropriate, with Kaplan-Meier survival analysis. Follow-up duration ranged from two to 24 months. Results Forty-five patients were included, of whom 37 (82.2%) were men, with a median age of 76.0 years. Twenty-four patients (53.3%) were elective admissions. Most procedures involved the superficial femoral artery (SFA), above-knee popliteal, and tibial segments, with Rutherford classes predominantly 4-5. Technical success was achieved in 91% (n = 41) of cases, and immediate procedural complications were infrequent. The 30-day readmission rate was 24.2% (n = 11). Severe calcification (PACSS grades 4-5) was not associated with major amputation (p = 0.67) or peri-procedural complications (p = 1.00). Thirty-day AFS was 75.6% (n = 37; 95% CI: 69.4%-91.7%), and 30-day overall survival was 88.9% (n = 40). Thirty-day mortality was significantly higher following emergency admission compared to elective admission (p = 0.03). At one year, major amputation occurred in 21.4% (n = 9) and all-cause mortality in 9.5%. Thirty-day readmission strongly predicted subsequent major amputation (66.7% versus 15.6%; p = 0.006). Conclusions In a predominantly critical limb-threatening ischemia (CLTI) cohort with heavy arterial calcification, adjunctive IVL achieved high technical success with low peri-procedural complication rates. Early limb and survival outcomes were largely driven by baseline disease severity and the urgency of presentation, with emergency admission and early readmission serving as adverse prognostic markers. IVL appears to be a safe and effective vessel preparation strategy in complex calcified disease, supporting the need for larger prospective studies to refine patient selection and long-term outcomes.

PMID:41841085 | PMC:PMC12989239 | DOI:10.7759/cureus.103548

Cureus. 2026 Feb 13;18(2):e103534. doi: 10.7759/cureus.103534. eCollection 2026 Feb.

ABSTRACT

Background and aim Caffeine is one of the most widely consumed psychoactive substances, with coffee serving as a primary source among university students globally. Many medical students use coffee to counter fatigue, stay alert, and maintain focus during extended study sessions and examinations. Caffeine works mainly by blocking adenosine receptors, which promotes wakefulness and temporarily improves attention and responsiveness. However, excessive consumption can lead to anxiety, disrupted sleep, and reduced cognitive function, potentially affecting academic performance. Despite the popularity of coffee, its overall impact on academic outcomes among medical students remains uncertain. This study aimed to explore the relationship between coffee consumption and academic performance among second-year medical students following their prelims examination. Methods This cross-sectional observational study was conducted among second-year medical students to assess the association between coffee consumption and academic performance. A structured, self-administered questionnaire was used to collect data on coffee intake patterns, demographic variables, lifestyle factors, and self-reported academic indicators. Academic performance data were obtained from institutional records of preliminary examinations. Statistical analysis was performed using appropriate descriptive and inferential methods to evaluate associations between coffee consumption and academic outcomes. Results A total of 249 students were included in the analysis. Of these, 172 students (69.1%) reported regular coffee consumption, while 77 students (30.9%) were nonconsumers. The mean theory prelim examination score was higher among coffee consumers compared to nonconsumers. Students consuming one to two cups of coffee per day (96 students, 38.6%) demonstrated higher mean examination scores than both nonconsumers and those consuming three or more cups per day (76 students, 30.5%). Examination scores also differed significantly across categories of sleep duration and reported caffeine-related adverse effects. Conclusions Coffee consumption was associated with academic performance among second-year medical students. Moderate intake was linked to improved academic outcomes, while excessive consumption, particularly when accompanied by sleep disturbances, was associated with poorer performance. These findings highlight the importance of moderation, adequate sleep, and healthy study habits in optimizing academic performance.

PMID:41841082 | PMC:PMC12989166 | DOI:10.7759/cureus.103534

Cureus. 2026 Feb 13;18(2):e103521. doi: 10.7759/cureus.103521. eCollection 2026 Feb.

ABSTRACT

Background Orthopaedics currently has the largest waiting list of any surgical speciality in the UK, and the number of patients awaiting elective surgery is continuing to climb. This retrospective study aims to quantify the impact of coding errors on elective surgery waiting times at a large UK district general hospital. Method Data from 381 patients who underwent operations on elective orthopaedic operating lists between January 1, 2025, and March 31, 2025, were included in the study. Most orthopaedic patients with acute issues are operated on a dedicated acute list. However, surges in acute referrals may result in re-purposing of elective operating lists to treat acute patients. These cases are at risk of being incorrectly coded as elective operations. The electronic booking code of the operation was compared with the case notes of each patient to determine if the coding as elective or acute was accurate. Results Of the 381 patients coded as elective, 44 were acute cases falsely coded as elective. The mean waiting time for these false elective cases was 10.86 days, in comparison to 247.24 days for the true elective cases. Overall, incorrect coding of trauma cases as elective cases artificially reduced the mean waiting time by 27.14 days, or 11.01%. A Mann-Whitney U test showed this to be statistically significant (p = 0.012). Conclusion Inaccurate electronic coding substantially and artificially reduces orthopaedic surgery waiting time. This is likely driven by human error and software errors that can prevent correct coding. These issues might be addressed through a review of the approved Electronic Patient Record (EPR) software systems, staff training, and a further push towards cold-site operating to better separate acute and elective orthopaedic care. Finally, a multi-centre study would demonstrate how far-reaching these coding errors are.

PMID:41841079 | PMC:PMC12989084 | DOI:10.7759/cureus.103521