Tag: statistics

Clin Anat. 2026 Mar 6. doi: 10.1002/ca.70107. Online ahead of print.

ABSTRACT

Injury to the lateral femoral cutaneous nerve (LFCN) is a well-recognized complication of total hip arthroplasty (THA) performed via the direct anterior approach (DAA), largely due to the anatomical variability of the nerve and its proximity to surgical incision lines. The present cadaveric study aimed to quantitatively evaluate the anatomical relationship between the LFCN and commonly used skin incisions in the DAA, including the bikini and longitudinal incision lines, to identify incision-related risk patterns and potential safer zones. Seventy-three thighs from 50 fresh Korean adult cadavers were used. Prior to dissection, bony landmarks and DAA incision lines were marked on the skin using pins. Dissection was then performed to expose the fascia lata and the LFCN, after which the distance between the incision line and the nerve was measured and statistically analyzed. Two principal emergence patterns of the LFCN, stem and divided, were identified, with the divided pattern being slightly more prevalent. The bikini incision intersected the anterior branch of the LFCN in all specimens, whereas the posterior branch was spared in approximately one-quarter of cases. In contrast, longitudinal incisions rarely intersected the anterior branch but frequently overlapped with the posterior branch; this overlap was more pronounced when the incisions were placed closer to the anterior superior iliac spine. These findings indicate that the risk of LFCN injury varies according to incision type and may be reduced by lateral adjustment in both incision lines, as well as by distal adjustment in the longitudinal incision. This quantitative anatomical evidence provides a foundation for optimizing DAA incision strategies in THA and may contribute to reducing postoperative sensory complications related to LFCN injury.

PMID:41793066 | DOI:10.1002/ca.70107

Neuropsychopharmacol Rep. 2026 Mar;46(1):e70107. doi: 10.1002/npr2.70107.

ABSTRACT

AIMS: Reduction of alcohol consumption is one of treatment goals to reduce harm among individuals with alcohol use disorder (AUD), a major worldwide health problem, for which nalmefene, an opioid receptor modulator, is used. In this study, the effect of nalmefene on ethanol (EtOH) intake, already reported, was evaluated in Wistar rats, as validation. In addition, effects of brexpiprazole, serotonin-dopamine activity modulator, alone and in combination with nalmefene were evaluated to investigate further treatment option for AUD.

METHODS: During the first training phase, animals had 10% EtOH as the only drinking fluid available for the first 5 days. Then, the animals had a 24-h free choice between EtOH and water for 39 days which is named the continual access paradigm. Thereafter, the limited access paradigm, which restricted the availability of 10% EtOH to 1 h every day, was carried out for 114 days. EtOH intake (g/kg/1 h) was determined by weighing 10% EtOH bottles before and after the limited EtOH access every day. Brexpiprazole (0.01-0.1 mg/kg, orally) and nalmefene (0.04-0.4 mg/kg, subcutaneously) were daily administered to rats 1 h or 20 min before starting the limited access paradigm for consecutive 4 days, respectively. The combination effect was evaluated using each subeffective dose of brexpiprazole and nalmefene which did not significantly reduce EtOH intake. The daily and the average EtOH intake for 4 days before and during the treatment with test compounds were statistically analyzed.

RESULTS: Brexpiprazole (0.1 mg/kg) and nalmefene (0.4 mg/kg) alone significantly decreased EtOH intake. Moreover, the combination of subeffective doses of brexpiprazole (0.01 mg/kg) and nalmefene (0.04 mg/kg) significantly and synergistically decreased EtOH intake.

CONCLUSION: These data suggest that brexpiprazole may have the potential to decrease alcohol intake in AUD patients. In addition, brexpiprazole may have a synergistic therapeutic effect with nalmefene in those patients.

PMID:41793049 | DOI:10.1002/npr2.70107

Biotechnol J. 2026 Mar;21(3):e70206. doi: 10.1002/biot.70206.

ABSTRACT

The development of robust Chinese Hamster Ovary (CHO) cell lines expressing high titers of monoclonal antibodies (MAbs) is central to bioprocess development. Following transfection and pool generation, clone selection is critical, as individual clones often behave differently in stirred-tank bioreactors. We propose a multivariate data analysis (MVDA) approach for clone selection that integrates productivity, growth, expression stability, and metabolism, with adaptable weighting based on process priorities. This method was applied to in-house data from CHO clones producing omalizumab. From 24 candidates, eight stable, high-performing clones were advanced for evaluation in 0.75-1 L bioreactors. MVDA revealed that including stability and metabolic parameters alters the ranking of lead clones compared with conventional screening. To assess scalability, cultures were run with or without air overlay to modulate dissolved CO₂. Cultures without overlay reached up to 25% pCO₂ (190 mmHg) and unexpectedly showed improved performance: 1.69-fold higher titer, 1.43-fold greater cell-specific productivity, 1.11-fold higher peak cell density, extended viability, and sustained product accumulation over 17-21 days. By integrating statistical tools and a historical dataset, our MVDA method identified a robust lead clone performing consistently across CO₂ conditions, supporting its application in early upstream bioprocess development.

PMID:41793045 | DOI:10.1002/biot.70206

Int Wound J. 2026 Mar;23(3):e70871. doi: 10.1111/iwj.70871.

ABSTRACT

Neoplastic foot ulcers are particularly challenging for dermatologists and specialists in hard-to-heal wounds because their location and comorbidities can delay accurate diagnosis. We performed a multicentre, retrospective study analysing clinical and histological data, focusing on neoplastic foot ulcers collected over the past 5 years. We evaluated patients’ demographic characteristics, clinical features, histological diagnosis, tumour onset and ulcer site. Statistical analyses were conducted using SPSS software, v.30. In total, 106 patients affected by foot skin ulcers were enrolled in the present protocol (52 women, 54 men). The mean age was 70.15 years. In most cases, the neoplastic ulcer was due to primary tumour ulceration. The dorsum of the foot was the most common site of neoplastic ulcers (66%). From a clinical perspective, most lesions were classified as ulcerated nodules (n = 58), ulcerated plaques (n = 8) or hypergranulating ulcers (n = 25), all with thickened, atypical edges. Histological diagnoses included melanoma (n = 45), non-melanoma skin cancers (n = 34), benign tumours (n = 18) and rarer malignancies (n = 9). A statistically significant correlation was found between histotype and clinical lesion type, and between age and histotype. The study provided preliminary data on the clinical and histological characteristics of neoplastic foot ulcers, warranting further exploration in a prospective, multicentre study.

PMID:41793027 | DOI:10.1111/iwj.70871

Int Wound J. 2026 Mar;23(3):e70852. doi: 10.1111/iwj.70852.

ABSTRACT

Split-thickness skin autografts are commonly used to treat extensive cutaneous defects. However, donor site morbidity, including pain, bleeding, and delayed epithelialization, remains a major clinical challenge. This study evaluates whether applying autologous platelet-rich plasma (PRP) to the donor site improves healing outcomes. A prospective cohort study was conducted at a tertiary-level academic hospital in Colombia. The study protocol was approved by the local Institutional Ethics Committee. Adult patients (> 18 years) undergoing split-thickness skin grafts for trauma, burns, oncologic resections, or chronic ulcers were included. Two groups were compared: the PRP group, in which autologous platelet-rich plasma was applied to the donor site, and the control group, which received standard wound care. The primary outcome was the quality of epithelialization at the donor site, while pain, assessed using the Numeric Rating Scale, was evaluated as a secondary outcome at multiple postoperative time points. Data were analysed using descriptive statistics and linear mixed-effects models adjusted for potential confounders, with statistical significance set at p < 0.05. A total of 46 patients were included (16 in the PRP group and 30 in the control group), with no significant demographic differences between groups. The PRP group demonstrated improved epithelialization quality, with lower Vancouver Scar Scale scores on postoperative days 7 and 14 (p < 0.05). Patients treated with PRP also reported a reduction of up to 50% in postoperative pain during early assessments (p < 0.001). These effects were maintained throughout the follow-up period, suggesting a sustained benefit of PRP on both healing quality and pain control. These findings suggest that autologous PRP application at split-thickness skin graft donor sites may enhance early epithelialization quality and reduce postoperative pain compared with standard wound care. PRP appears to be safe and may represent a useful adjunct to promote improved wound healing and patient recovery in reconstructive surgery. However, larger randomised controlled trials are required to confirm these findings and to establish the clinical effectiveness of autologous PRP in this setting.

PMID:41793011 | DOI:10.1111/iwj.70852

Neural Netw. 2026 Feb 26;200:108775. doi: 10.1016/j.neunet.2026.108775. Online ahead of print.

ABSTRACT

In this paper, we propose a single-qubit graph classifier that combines classical graph representation with quantum computing. Through a lightweight architecture, it achieves flexible and efficient graph data processing. This model delegates the task of aggregating node features that do not require inference to a classical subroutine, and optimizes the key weight training process with quantum programs, thereby constructing a basic graph classifier that uses only one qubit. Experimental results show that in binary classification tasks, the proposed single-qubit classifier demonstrates strong competitiveness in terms of performance when compared with traditional algorithms and quantum algorithms. Additionally, we utilize a parallel training scheme for multiple single-qubit classifiers to effectively enhance performance in multi-classification tasks. Evaluations conducted in different quantum noise simulation environments indicate that the proposed model has good robustness, and the parallel training scheme for multiple classifiers further enhances the model’s robustness in multi-classification tasks. More importantly, this model can be flexibly combined with various classical graph neural networks, providing a way to promote the application of quantum graph neural networks in diverse scenarios.

PMID:41791178 | DOI:10.1016/j.neunet.2026.108775

Neural Netw. 2026 Mar 1;200:108753. doi: 10.1016/j.neunet.2026.108753. Online ahead of print.

ABSTRACT

In this paper, we introduce a novel algorithm for image segmentation, which is based on the Allen-Cahn (AC) energy function. Our methodology involves calculating the energy feature at a local level in an image by means of the sliding window technique on the image matrix, which ultimately produces the energy matrix necessary for segmenting the image. Subsequently, constraints are constructed using the extreme values in the energy matrix. By varying the parameters in the constraints and the size of the sliding window, image segmentation results are obtained for different demand purposes. This paper empirically analyzes various simple and complex images, demonstrating the algorithm’s effectiveness in segmentation across different complexities and its excellent performance in agronomy and medicine. We also compare our method with other state-of-the-arts and our algorithm exhibits significant advantages in terms of time-saving. In order to further optimise the parameter selection process, we improve the algorithm so that it can autonomously output the parameters that make the segmentation results optimal. Additionally, we conduct experiments on several classical image segmentation datasets, as well as evaluating the segmentation results through the introduction of evaluation metrics, to demonstrate the effectiveness and applicability of our optimised algorithm. Our method demonstrates outstanding performance in image segmentation experiments on the CO-SKEL dataset, with an average segmentation time of 0.2 s. The accuracy exceeds 95%, and precision, recall, and F1 scores all surpass 90%. Even under various noise interferences, the segmentation accuracy of the algorithm remains above 94%, highlighting its efficiency and robustness.

PMID:41791175 | DOI:10.1016/j.neunet.2026.108753

Clin Oncol (R Coll Radiol). 2026 Feb 14;52:104084. doi: 10.1016/j.clon.2026.104084. Online ahead of print.

ABSTRACT

AIMS: Brain metastases (BMs) represent the most common intracranial tumours in adults with advanced solid cancers, significantly impacting morbidity and mortality. While the emergence of systemic therapies such as immunotherapy (IT) and targeted therapy (TT) has improved survival outcomes, the interaction of these modalities with stereotactic radiotherapy/radiosurgery (SRS/SRT) remains poorly explored. This study aims to evaluate the safety, local control (LC), and efficacy of combining SRS/SRT with IT or TT in patients with BM.

MATERIALS AND METHODS: This prospective, monocentric study (“RaBITT Trial”) analysed patients with BM treated with SRS/SRT using the CyberKnife system (Accuray) between May 2020 and May 2023. Patients received IT or TT in conjunction with SRS/SRT. Outcomes assessed included LC, overall survival (OS), disease-free survival (DFS), and next-line systemic treatment-free survival (NEST-FS). Toxicity, including radionecrosis and haemorrhage, was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 criteria. Statistical analysis employed Kaplan-Meier curves and univariate (UVA) and multivariate (MVA) regression models.

RESULTS: We analysed 45 patients with a total of 225 BMs. The LC rate at 1 and 2 years was 85.7% and 79.8%, respectively. The overall response rate was 85.3%, with 56 complete responses (CRs). Multivariate analysis identified a higher biological effective dose with an α/β ratio of 10 and prescription isodose as predictors of CR. DFS rates at 1 and 2 years were 37.1% and 27.5%, respectively, while OS rates were 52.5% and 44.7%, respectively. NEST-FS rates at 1 and 2 years were 35.9% and 25.5%, respectively. Toxicity analysis revealed a radionecrosis rate of 20% for patients (6.7% of total lesions), with most cases being asymptomatic. Intralesional haemorrhage occurred in 1.7% of lesions, predominantly in melanoma and lung cancer patients.

CONCLUSION: The combination of SRS/SRT with IT or TT yields high rates of LC and overall response with a manageable safety profile, emphasising the importance of personalised dosimetric planning and careful toxicity monitoring. Despite promising outcomes, the study’s monocentric nature and limited sample size highlight the need for multicenter trials with extended follow-up to optimise treatment strategies and better understand long-term risks and benefits.

PMID:41791143 | DOI:10.1016/j.clon.2026.104084

J Neurosurg Spine. 2026 Mar 6:1-9. doi: 10.3171/2025.9.SPINE241288. Online ahead of print.

ABSTRACT

OBJECTIVE: Limited research has explored the impact of predominant back pain (pBP) versus predominant leg pain (pLP) in patients undergoing unilateral biportal endoscopic lumbar decompression (UBE-LD). This study aimed to evaluate and compare the perioperative and postoperative clinical outcomes, using patient-reported outcome measures (PROMs) and minimal clinically important difference (MCID), between patients with pBP and pLP who underwent UBE-LD.

METHODS: Patients who underwent primary UBE-LD were divided into either the pBP or pLP cohort. Exclusion criteria included patients with a diagnosis of degenerative scoliosis, trauma, malignancy, or infection. Demographic, perioperative characteristics, PROMs, and MCID were compared between cohorts using inferential statistics. PROMs were collected at preoperative and postoperative 6-week, 12-week, and 6-month time points. Assessed PROMs included the Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Veterans Rand 12-Item Health Survey (VR-12) physical component score (PCS), VR-12 mental component score (MCS), visual analog scale (VAS) for back pain, VAS for leg pain, and Oswestry Disability Index (ODI). MCID attainment was determined by comparing the change in PROMs to established thresholds in the literature.

RESULTS: A total of 98 patients were included in the study, with 52 in the pBP cohort and 46 in pLP cohort. After analysis, there were no significant differences in baseline demographic or perioperative characteristics between the two groups. The majority of patients had a diagnosis of herniated nucleus pulposus (81.6%), central stenosis (93.9%), and foraminal stenosis (77.6%). At 6 months, both cohorts experienced significant postoperative improvements in PROMIS-PF, VAS back pain, VAS leg pain, VR-12 PCS, and ODI scores (all p ≤ 0.011). VR-12 MCS scores did not demonstrate sustained postoperative improvement in either cohort. High rates of MCID achievement were observed across both cohorts for multiple PROMs, with no statistically significant differences in MCID attainment between patients with pBP and pLP at any postoperative time point.

CONCLUSIONS: Regardless of the preoperative predominant pain location, patients undergoing UBE-LD reported significant improvements in physical function, back and leg pain, and disability. Patients in both cohorts demonstrated improvements in mental health outcomes, with comparable MCID achievement rates for VR-12 MCS. These findings suggest that UBE-LD might be effective for patients with both predominant back and leg pain presentations, although differences in specific outcome domains should be interpreted with caution due to potential selection bias. Consideration of predominant pain location might help inform preoperative patient counseling regarding expected outcomes following UBE-LD.

PMID:41791117 | DOI:10.3171/2025.9.SPINE241288

J Neurosurg. 2026 Mar 6:1-6. doi: 10.3171/2025.10.JNS251032. Online ahead of print.

ABSTRACT

OBJECTIVE: Patients experiencing ischemic strokes typically develop substantial cognitive decline. Intracranial atherosclerotic disease (ICAD) is a common stroke etiology that exposes patients to high and prolonged risks of recurrence. The ERSIAS-PC (Encephaloduroarteriosynangiosis revascularization for symptomatic intracranial atherosclerotic steno-occlusive performance criterion) phase II trial showed a lower risk of recurrent stroke in patients who underwent encephaloduroarteriosynangiosis (EDAS) plus intensive medical management (IMM). In the current study, the authors evaluate factors contributing to cognitive decline in patients with symptomatic ICAD treated with EDAS revascularization.

METHODS: ERSIAS-PC patients without aphasia who had completed at least 1 year of follow-up were included this post hoc analysis. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) at baseline and each follow-up and was classified as improved/preserved or worsened. Classification and regression tree (CART) analysis was used to identify factors associated with changes in cognitive function. The factors considered were age, sex, stenosis versus occlusion, baseline modified Rankin Scale score, good collateralization, and compliance with diabetes mellitus (DM), hypertension, and hyperlipidemia (HLD) treatments.

RESULTS: Of the 52 ERSIAS-PC patients, 39 were included in this subgroup analysis. The median age was 46 (IQR 37.0-56.0) years, and 27 (69.2%) patients were female. The mean MoCA score was 22.4 ± 4.9 at baseline and 23.9 ± 4.9 at the 1-year follow-up among the 52 patients in the ERSIAS-PC trial population. Among the 39 patients in this subgroup analysis, the MoCA score improved or remained stable in 33 (84.6%) and declined in 6 (15.4%). CART analysis indicated that the most relevant factor for an improved MoCA score after surgery was compliance with DM treatment (94.5% yes vs 74.2% no, p = 0.02). Other factors indicating a nominal though not statistically significant influence were HLD treatment (83.3% yes vs 60.5% no, p = 0.2) and stenosis (99.1% vs 80.9% occlusion, p = 0.6).

CONCLUSIONS: Compliance with DM treatment was significantly associated with cognitive preservation in patients with symptomatic ICAD treated with EDAS. The study findings emphasize the importance of the IMM of stroke risk factors in patients with intracranial atherosclerosis, even after surgical revascularization.

PMID:41791115 | DOI:10.3171/2025.10.JNS251032