Tag: statistics

Front Glob Womens Health. 2026 Jun 2;7:1775422. doi: 10.3389/fgwh.2026.1775422. eCollection 2026.

ABSTRACT

OBJECTIVE: To evaluate the influence of partnership status on the perception of menopausal symptoms and quality of life in women undergoing hormone replacement therapy (HRT).

METHODS: The study included 60 menopausal women aged 40-85 years with significant climacteric symptoms. Participants were divided into two groups according to relationship status: women living in a stable partnership (n = 30) and women without a partner for at least one year (n = 30). Menopausal symptoms and quality of life were assessed using the Menopause Rating Scale (MRS) and the Manchester Short Assessment of Quality of Life (MANSA). All participants received combined HRT. Assessments were performed at baseline and after three months of therapy. Changes in symptom severity (ΔMRS) and quality of life (ΔMANSA) were analyzed, and Pearson correlation coefficients with corresponding p-values were used to assess relationships between variables.

RESULTS: HRT was associated with improvement in menopausal symptoms and quality of life in both groups. However, women living in a partnership showed a greater reduction in MRS scores and a greater increase in MANSA scores compared to women without a partner. After three months of HRT, statistically significant correlations (p < 0.05) between hormonal levels (estradiol, FSH), menopausal symptoms, and quality of life were observed exclusively in partnered women.

CONCLUSION: HRT improves menopausal symptoms and quality of life; however, partnership status appears to play a moderating role. A stable partnership may facilitate the integration of psychobiological processes of hormonal changes and contribute to improved subjective adaptation to menopause.

PMID:42312311 | PMC:PMC13269051 | DOI:10.3389/fgwh.2026.1775422

Liver Cancer. 2026 Apr 16. doi: 10.1159/000551935. Online ahead of print.

ABSTRACT

INTRODUCTION: The prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) remains dismal. Although systemic therapy is the standard of care, its effectiveness is limited. This study aimed to compare the efficacy and safety of transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) combined with systemic therapy versus systemic therapy alone in patients with HCC and PVTT.

METHODS: We retrospectively analyzed 478 patients newly diagnosed with HCC and PVTT between January 2021 and December 2024. Propensity score matching (PSM) was used to balance baseline characteristics. Outcomes compared between the combination therapy group (TACE/HAIC plus targeted therapy and immunotherapy, n = 374) and the systemic therapy group (n = 104) included overall survival (OS), progression-free survival (PFS), tumor response, and adverse events.

RESULTS: After PSM (184 vs. 102 patients), the combination therapy group showed significantly longer median OS (15.7 vs. 5.9 months; hazard ratio [HR] = 0.524, 95% confidence interval [CI]: 0.391-0.702; p < 0.001) and PFS (7.0 vs. 3.6 months, HR = 0.732, 95% CI: 0.558-0.959; p = 0.024). The disease control rate was also higher in the combination therapy group (43.5% vs. 27.5%, p = 0.007). Subgroup analyses revealed pronounced survival benefits in patients with Vp4 PVTT and those with Child-Pugh B liver function. Although adverse events were more frequent in the combination therapy group, the incidence of grade 3-4 toxicities was generally comparable between the two groups.

CONCLUSION: In HCC patients with PVTT, combining TACE or HAIC with systemic therapy significantly improves survival outcomes compared to systemic therapy alone, with acceptable safety. This multimodal approach offers a promising treatment strategy, particularly for patients with advanced PVTT or impaired liver function.

PMID:42312291 | PMC:PMC13271749 | DOI:10.1159/000551935

Int J Biomed Imaging. 2026 Jun 16;2026:4763936. doi: 10.1155/ijbi/4763936. eCollection 2026.

ABSTRACT

BACKGROUND: Brain tumour detection and analysis using medical imaging requires the extraction of both local spatial features and global contextual representations. Although convolutional neural networks (CNNs) excel at capturing local spatial patterns and Transformer-based architectures model long-range dependencies effectively, the optimal architectural paradigm for clinical deployment remains unresolved. This systematic review and meta-analysis evaluates hybrid CNN-Transformer architectures for brain tumour detection, focusing on the integration of local and global feature learning, diagnostic accuracy and computational efficiency. The roles of generative adversarial networks (GANs) for addressing data scarcity and multimodal imaging fusion for diagnostic completeness are also critically examined.

METHODS: A systematic search was conducted across IEEE Xplore, PubMed, Scopus and Google Scholar for studies published between January 2021 and May 2025. From 1876 initially identified articles, 94 met the prespecified inclusion criteria following quality assessment using the QUADAS-2 and ROBINS-I frameworks. A random-effects meta-analysis of diagnostic accuracy was performed using the DerSimonian-Laird estimator, with statistical heterogeneity quantified using I² and publication bias assessed using funnel plot asymmetry and Egger’s test. Computational efficiency was standardised to GigaFLOPs using a reference input of 240 × 240 × 155 voxels (BraTS benchmark), with FLOP estimates derived from primary publications where available and bounded by theoretical complexity formulas otherwise, with estimated values explicitly distinguished throughout.

RESULTS: Across all 94 included studies, the pooled diagnostic accuracy was 93.5% (95% CI: 92.7%-94.4%); however, confirmed publication bias (Egger’s p = 0.043) indicates this represents an upper-bound approximation rather than an unbiased population estimate. Because subgroup study counts were insufficient for formal random-effects pooling (CNN-only: n = 3; Transformer-only: n = 2; CNN-Transformer hybrid: n = 4; minimum recommended n = 10 per subgroup), no subgroup meta-analysis was performed. Instead, descriptive mean accuracies are reported as hypothesis-generating observations only: CNN-only models 91.7%, Transformer-only models 93.6% and CNN-Transformer hybrid models 94.6%. These figures must not be interpreted as pooled meta-analytic estimates; they reflect mean observed accuracy across a small number of included studies and are reported solely to illustrate directional trends consistent with the mechanistic rationale for hybridisation. Substantial heterogeneity was observed (I² = 78.3%; p < 0.001). Three integration paradigms were identified: sequential (45% of models; 93.8% accuracy; 1.8 GFLOPs), parallel (32%; 94.3%; 2.8 GFLOPs) and hierarchical (23%; 94.9%; 3.5 GFLOPs). Parallel architectures demonstrated optimal clinical viability, balancing accuracy with a mean inference time of 2.1 s. GAN-based augmentation improved rare tumour class detection by 7%-10%, with conditional GANs outperforming vanilla architectures. Multimodal MRI + PET fusion achieved 94.2% accuracy at 2.8 GFLOPs, whereas triple-modality integration yielded marginal additional gains (95.1%) at substantially elevated computational cost (9.1 GFLOPs). Notably, 65% of included studies used the BraTS benchmark exclusively, and hybrid model accuracy declined from 94.6% on high-grade gliomas to 88.3% on low-grade gliomas, with hybrid architectures exhibiting 2.3× greater susceptibility to Gaussian noise than CNN-only equivalents, limitations that constrain generalisation to real-world clinical settings.

CONCLUSIONS: Descriptive comparison of mean observed accuracies based on study counts is insufficient for confirmatory meta-analysis, suggesting hybrid CNN-Transformer architectures may offer diagnostic accuracy advantages over CNN- and Transformer-only approaches; this observation is hypothesis-generating only and requires validation in a larger, more balanced evidence base. Among integration strategies, parallel architectures demonstrated the most favourable accuracy efficiency balance in the reviewed evidence. GANs and multimodal imaging function as essential architectural enablers, addressing data scarcity and diagnostic incompleteness, respectively. Significant challenges remain in computational efficiency, noise robustness and generalisation to rare tumour subtypes, representing priority directions for future research.

PMID:42312286 | PMC:PMC13270495 | DOI:10.1155/ijbi/4763936

J Indian Assoc Pediatr Surg. 2026 May-Jun;31(3):406-417. doi: 10.4103/jiaps.jiaps_288_25. Epub 2026 May 5.

ABSTRACT

BACKGROUND: While Wilms tumor (WT) is primarily associated with mutations in WT1, CTNNB1 and WTX genes, these alterations account for only ~30% of cases, suggesting a broader, unexplored genetic landscape.

OBJECTIVE: The objective of this study was to comprehensively characterize novel genetic variants in WT through whole-genome sequencing analysis of paired tumor and normal renal tissues.

MATERIALS AND METHODS: Somatic exonic variants (paired, malignant, and normal renal tissues) in the whole genome of the study cohort were filtered for exonic regions, annotated using multiple prediction tools (SIFT, MutationTaster, Combined Annotation Dependent Depletion [CADD]), and analyzed for functional relevance using cBioPortal and STRING databases.

RESULTS: Seventy-one variants in 16 genes were consistently present across the study cohort. Statistically, KRT18, CNN2, MUC16, MUC19, and FCGBP harbor 74.6% (53/71) of the variations identified. Six genes (MAST2, MUC19, KRT3, MUC16, FCGBP, and ANKRD36) were predicted to have a “high” likelihood of being involved in cancer. Twenty-three variants pertaining to KRT18, CNN2, WDR89, MTCH2, DDX11, GXYLT1, and ANKRD36 had a CADD score >20, with 10 KRT18 variants having DANN scores ≥0.75. Significant clustering of variants in “hotspot-exons” pertaining to KRT18 (exon 1), CNN2 (exon 7), and MUC16 (exons 23 and 56) was observed. The implicated genes were found to interact with multiple pathways involved in cell cycle regulation, apoptosis, immune signaling, and developmental processes.

CONCLUSIONS: This study significantly expands WT’s genetic landscape by identifying 71 variants across 16 genes, including several genes with established roles in other cancers (MUC16, KRT18, FCGBP) that have not been previously implicated in WT, as well as genes with limited prior cancer associations. The identification of mutation hotspots and WT-specific gene associations provides new insights into WT development and potential therapeutic targets. These findings warrant further functional studies to validate their role in WT pathogenesis and potential as diagnostic or therapeutic targets.

PMID:42312281 | PMC:PMC13271734 | DOI:10.4103/jiaps.jiaps_288_25

J Indian Assoc Pediatr Surg. 2026 May-Jun;31(3):363-368. doi: 10.4103/jiaps.jiaps_180_25. Epub 2026 May 5.

ABSTRACT

INTRODUCTION: Multiple functional scoring systems exist to evaluate bowel and urinary outcomes in patients with anorectal malformations (ARM). However, their correlation with patient-reported quality of life (QoL) remains uncertain. This study aimed to assess the predictive value of these functional scores in determining long-term QoL among adolescents and adults with ARM.

MATERIALS AND METHODS: We conducted a cross-sectional study including patients aged ≥12 years who had undergone definitive surgical correction for ARM, irrespective of age at operation. Functional outcomes were evaluated using the Kelly, Rintala, Holschneider, pediatric incontinence/constipation score (PICS), lower urinary tract symptoms, and Bowel function score (BFS) systems. QoL was assessed using a self-reported 1-10 numerical scale, where higher scores indicated better perceived well-being. Correlations between functional outcomes and QoL were analyzed statistically.

RESULTS: Twenty-three patients (17 females, 6 males) with a mean age of 15.96 ± 4.65 years were assessed. The majority (74%) had low-type ARM. The Kelly and BFS scores demonstrated the strongest correlation with each other (P < 0.001). However, none of the functional scoring systems showed a significant correlation with patient-reported QoL.

CONCLUSIONS: Functional scoring systems, while useful for objective outcome assessment, do not reliably predict long-term QoL in ARM survivors, particularly those with low malformations. Patient-reported QoL appears to be shaped by broader influences, including psychosocial adaptation, coping mechanisms, cultural perceptions, and response shift. These findings highlight the need for validated QoL instruments and multicenter studies incorporating both functional and psychosocial domains.

PMID:42312250 | PMC:PMC13271698 | DOI:10.4103/jiaps.jiaps_180_25

Geriatr Gerontol Int. 2026 Jun;26(6):e70604. doi: 10.1111/ggi.70604.

ABSTRACT

BACKGROUND: Anticholinergic burden is common in older adults and has been associated with adverse outcomes, although its association with mortality is inconsistent. This study aimed to investigate the association between anticholinergic burden and time-to-death in older adults and to examine whether this association differs according to baseline frailty status.

METHODS: This retrospective cohort study analyzed 2739 adults (65-95 years) who attended a geriatric clinic between 2013 and 2020 and had a documented date of death during the study period. Anticholinergic burden was categorized by anticholinergic cognitive burden (ACB) scale scores as low (0-1) or high (≥ 2). Frailty was defined as a clinical frailty scale (CFS) score ≥ 4. Time-to-death was defined as the interval between the index geriatric visit and death. Subgroup analyses explored frailty, polypharmacy, and major comorbidities.

RESULTS: Among the study population, high ACB was associated with a significantly shorter time-to-death (log-rank p = 0.013). After adjustment for age, sex, and frailty status, high ACB remained independently associated with a higher hazard of death at both 1-year (HR 1.20, 95% CI 1.03-1.40) and 5-year follow-up (HR 1.15, 95% CI 1.05-1.28). In stratified analyses, this association was observed among frail individuals (log-rank p = 0.007), whereas no significant association was observed among non-frail participants (p = 0.767).

CONCLUSIONS: Higher anticholinergic burden was independently associated with shorter time-to-death in older adults, with the association predominantly observed in frail individuals. These findings underscore the need for routine frailty and anticholinergic burden assessment in geriatric care and support targeted deprescribing in frail populations.

PMID:42310484 | DOI:10.1111/ggi.70604

Cancer Med. 2026 Jun;15(6):e72052. doi: 10.1002/cam4.72052.

ABSTRACT

INTRODUCTION: Approximately 12.4% of patients with lung cancer experience depression after cancer diagnosis. Asian, Native Hawaiian, and Pacific Islanders (ANHPIs) constitute a large group with heterogeneity. The aim of this study is to examine the racial differences in depression risk, comparing overall ANHPI and ANHPI ethnic groups to non-Hispanic White (NHW) patients with lung cancer.

METHOD: We utilized the Surveillance, Epidemiology and End Results (SEER)-Medicare and SEER-Consumer Assessment of Healthcare Providers and System (CAHPS) dataset. We included patients with primary lung cancer who were aged 66 and older, diagnosed from 2000 to 2017 with full coverage of Medicare Part A and B. One ANHPI patient with lung cancer was matched to three NHW patients with lung cancer based on sex, diagnosis age, and diagnosis year. We used the Cox proportional hazards model to estimate the differences in depression incidence among ANHPI and NHW patients with lung cancer.

RESULTS: Overall ANHPI, Chinese, Japanese, Filipino, Asian Indian or Pakistani, and other Asian patients with lung cancer had a lower incidence of depression than NHW patients with lung cancer. Korean patients with lung cancer (HR 1.62, 95% CI 1.05-2.51) had a higher incidence of depression when compared to Chinese patients with lung cancer. ANHPI and NHW males had a lower incidence of depression compared to female lung cancer patients.

CONCLUSION: Korean patients with lung cancer may have a higher incidence of depression than Chinese comparisons. More research to investigate the heterogeneity and underdiagnosis of depression risk among older ANHPI groups is needed.

PMID:42310483 | DOI:10.1002/cam4.72052

Microbiologyopen. 2026 Jun;15(3):e70326. doi: 10.1002/mbo3.70326.

ABSTRACT

Colorectal cancer (CRC) is one of the most common types of cancer worldwide, and the gut microbiome plays a crucial role in its development. In the study, we examine the variation in gut microbial community composition among individuals diagnosed with CRC based on human fecal samples. A systematic search of online databases, including MEDLINE (PubMed), Web of Science, Embase, and Scopus up to March 2026, following the requirements outlined in the PRISMA guideline. The search strategy was based on a combination of keywords, including “colorectal cancer,” “gut microbiome”, and “feces.” The study analyzed 43 research articles on colorectal cancer microbiome. Most investigations utilized culture-independent techniques, revealing variations in microbial profiles between colorectal cancer cases and healthy controls. Fusobacterium and Porphyromonas emerged as potential colorectal cancer biomarkers, while multi-bacteria predictive models showed promise in enhancing colorectal cancer detection sensitivity and specificity. In this review, we will explore how advanced sequencing techniques have the potential to complement current non-invasive methods for early diagnosis and prevention of colorectal cancer. This includes conducting studies with robust statistical power and consistent, replicable methodologies, taking into consideration host factors, and performing external validation of predictive models.

PMID:42310475 | DOI:10.1002/mbo3.70326

CPT Pharmacometrics Syst Pharmacol. 2026 Jul;15(7):e70278. doi: 10.1002/psp4.70278.

ABSTRACT

The development of new methods for covariate model building (CMB) in population pharmacokinetics (popPK) highlights the need for a standardized evaluation framework for method benchmarking. This data paper introduces PMX-CovEval, a framework including a collection of datasets based on 127 distinct scenarios. These scenarios aim to reflect the diversity of models, available clinical studies, and covariates encountered in real-world applications, while remaining limited enough in number to encourage their practical use. To support the evaluation of standard CMB techniques available on PsN and Monolix, model files for NONMEM and Monolix are provided alongside the datasets. Additionally, empirical Bayes estimates (EBEs) from the true base models are included to facilitate the testing of EBE-based regression approaches. By offering pharmacokinetic (PK) datasets, model files, and EBEs in a unified resource, PMX-CovEval provides a standardized, reproducible framework for evaluation and systematic comparison of CMB strategies in popPK. Initial benchmarking results are also provided.

PMID:42310474 | DOI:10.1002/psp4.70278

Nature. 2026 Jun 17. doi: 10.1038/s41586-026-10664-8. Online ahead of print.

ABSTRACT

Climate-induced permafrost thaw unlocks large stores of organic carbon that are mineralized and emitted as carbon dioxide (CO₂) from rivers to the atmosphere¹. Concurrently, warming and permafrost thaw can increase mineral weathering rates, thus affecting the release and sequestration of inorganic carbon^2-4. Yet how these biological and geological carbon cycles interact and jointly affect CO₂ dynamics (emission compared with drawdown) in permafrost rivers remains unknown⁵. Here we combine CO₂ emissions, organic and inorganic solute concentrations, dual carbon isotopes (δ¹³C-Δ¹⁴C) and geochemical modelling to infer how permafrost thaw may affect river biogeochemistry over decades to centuries across the Qinghai-Tibet Plateau. Leveraging a gradient of thermal permafrost degradation, we find that river CO₂ emissions decline, whereas solute fluxes from rock weathering increase with decreasing permafrost cover. Across this region, net CO₂ drawdown fluxes from rock weathering are about 35% of river CO₂ emissions, varying from around 15% in catchments with continuous permafrost to more than 100% in catchments with discontinuous or isolated permafrost. Thus, carbon fluxes from chemical weathering may become increasingly important with ongoing permafrost thaw, potentially even outpacing river CO₂ emissions. Our findings disentangle the interplay between biological and geological carbon fluxes that are important for the cryosphere and the global carbon cycle.

PMID:42310459 | DOI:10.1038/s41586-026-10664-8