Tag: statistics

Discov Oncol. 2026 Feb 1. doi: 10.1007/s12672-026-04459-6. Online ahead of print.

ABSTRACT

BACKGROUND: Trifluridine/Tipiracil (TAS-102) is an effective agent for the late-line treatment of metastatic colorectal cancer (mCRC). Combining TAS-102 with bevacizumab improves outcomes but may increase adverse events. We conducted a real-world, retrospective, exploratory comparison of two dosing schedules (bi-weekly vs. four-weekly) to describe efficacy, safety, and potential molecular and clinical correlates.

METHODS: We analyzed patients with mCRC who were treated with TAS-102 in combination with bevacizumab as late-line therapy from January 2020 to February 2023. Regimen assignment followed physician-patient shared decision-making based on clinical factors and local practice changes after emerging evidence, not randomization. Endpoints included progression-free survival (PFS), overall survival (OS), adverse events (AEs). Analyses were exploratory and hypothesis-generating, with multivariable Cox models for selected covariates.

RESULTS: A total of 92 patients were enrolled in this study. Median PFS was 3.2 months (bi-weekly) vs. 3.7 months (four-weekly), and median OS was 10.0 vs. 9.3 months, with no statistically significant differences. KRAS mutation was associated with inferior OS (7.7 vs. 11.8 months; P = 0.018), whereas TP53 was not. Eastern Cooperative Oncology Group performance status (ECOG-PS) = 2 independently predicted shorter PFS and OS; prior bevacizumab exposure correlated with shorter PFS but not OS. Common adverse events in patients were neutropenia (63.0%), leukopenia (67.0%), anemia (44.6%), malaise (55.4%), nausea (45.7%), anorexia (31.5%), and diarrhea (23.9%).

CONCLUSION: In this retrospective, real-world study, the two regimens demonstrated comparable disease control, and the bi-weekly regimen appeared to be better tolerated, representing a reasonable potential alternative. Nevertheless, these findings should be interpreted as exploratory, and future prospective studies are warranted.

PMID:41621001 | DOI:10.1007/s12672-026-04459-6

Orv Hetil. 2026 Feb 1;167(5):171-179. doi: 10.1556/650.2026.33450. Print 2026 Feb 1.

ABSTRACT

INTRODUCTION: Surface-guided radiotherapy is an increasingly widely used technique that can monitor patient body surface movement in real time in a non-invasive manner.

OBJECTIVE: To evaluate the setup accuracy of surface-guided radiotherapy in lung stereotactic body radiotherapy compared to conventional cone-beam CT-based positioning.

METHOD: A retrospective single-center analysis was performed on 12 patients treated with lung surface-guided radiotherapy between 2022 and 2025. 6 patients were positioned using surface guidance with cone beam CT verification, while 6 were treated using cone-beam CT alone. Table couch corrections in three translational (vertical, longitudinal, lateral) and three rotational axes (pitch, roll, rotation) were recorded. Group differences were analyzed using the independent-samples Mann-Whitney U-test.

RESULTS: The resultant 3D translational displacement was significantly lower in the surface-guided group (median: 0.40 cm) compared to the control group (0.63 cm; p = 0.002). Among individual translational components, only the vertical axis showed a significant reduction in the surface-guided group (p<0.001), while longitudinal and lateral shifts did not differ significantly (p>0.05). In contrast, the resultant 3D rotational displacement was higher with surface-guided radiotherapy (median: 2.19° vs. 1.13°; p = 0.013). None of the individual rotational axes (pitch, roll, rotation) showed statistically significant differences (p>0.05).

DISCUSSION: These findings are consistent with previous literature demonstrating that surface guidance improves translational accuracy in thoracic radiotherapy, particularly in the vertical direction. The slightly increased rotational deviations observed in the surface-guided group may be attributed to the absence of a 6D treatment couch, as the system primarily optimizes translational alignment. Given the small sample size, further multicenter studies with larger cohorts and different surface guidance platforms are warranted.

CONCLUSION: Surface-guided radiotherapy enhances positioning accuracy in lung sterotactic radiotherapy, mainly by reducing translational displacements. However, optimal control of rotational errors may require the integration of 6D couch capabilities or dedicated rotational correction techniques. Orv Hetil. 2026; 167(5): 171-179.

PMID:41620991 | DOI:10.1556/650.2026.33450

Curr Med Res Opin. 2026 Feb 1:1-11. doi: 10.1080/03007995.2026.2621287. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVE: Disordered mineral metabolism is associated with adverse outcomes in dialysis populations, but its prognostic significance in non-dialysis CKD is less well defined. This study evaluated elevated serum alkaline phosphatase (ALP) and hyperphosphatemia as predictors of mortality and renal outcomes in non-dialysis CKD.

METHODS: In this prospective cohort study, patients from a tertiary renal clinic were followed for >12 months. Elevated ALP was defined as >105 U/L in females or >130 U/L in males; hyperphosphatemia as phosphate >4.5 mg/dL. The primary outcome was mortality, and the secondary outcome was a composite endpoint (ESKD progression, dialysis initiation, or doubling of serum creatinine). Kaplan-Meier, log-rank, and Cox regression analyses were performed (STATA; p <.05).

RESULTS: Among 360 patients (mean age 53.7 ± 13.9 years; follow-up 14 ± 4.2 months), elevated ALP was present in 31.7% and was associated with higher mortality (24.6% vs 8.9%, p <.001) and composite events (45.6% vs 33.9%, p = .03). Hyperphosphatemia occurred in 38.1% and was associated with increased mortality (21.2% vs 9.4%, p = 0.002) and composite outcomes (57.4% vs 25.6%, p <.001). Elevated ALP independently predicted mortality (HR = 2.37; 95% CI = 1.36-4.15; p = .002) but not composite outcomes. Hyperphosphatemia predicted both mortality (HR = 2.59; 95% CI = 1.47-4.57; p = .001) and composite events (HR = 2.55; 95% CI = 1.80-3.60; p <.001). Subgroup analyses demonstrated the highest mortality risk among patients with concurrent elevations in ALP and serum phosphate.

CONCLUSIONS: Elevated ALP independently predicted mortality, while hyperphosphatemia predicted both mortality and CKD progression. Monitoring these biomarkers may improve risk stratification and guide future interventional studies.

PMID:41620976 | DOI:10.1080/03007995.2026.2621287

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2026 Feb;42(2):129-139.

ABSTRACT

Objective To investigate the effect of N-acetylglucosamine transferase 4 (GalNAc-T4) on the mitochondrial autophagy in H9c2 cell injury model induced by hypoxia/reoxygenation (H/R) in high glucose (HG) environment, and its regulatory mechanism on extracellular signal regulated kinase 1/2 (ERK1/2) signaling pathway. Methods The cell experiments were divided into five groups. Control group (Control): Cells were transfected with pc-NC cells. HG group: 50 mmol/L glucose was added to the culture medium, and cells were transfected with pc-NC. HG+H/R group: In addition to the HG treatment, cells were subjected to a low oxygen environment for 6 hours, followed by transfection with the pc-NC vector. Overexpression group (pc): Cells were transfected with the pc while undergoing HG+H/R treatment. ERK1/2 agonist epidermal growth factor (EGF) group: Cells were treated with HG+H/R and transfected with the pc, supplemented with 20 ng/mL EGF in the culture medium. The proliferation activity, apoptosis rate, mitochondrial membrane potential, the levels of reactive oxygen species (ROS), iron ions, and mitochondrial autophagy in each group of cells were detected. The expressions of GalNAc-T4, ERK1/2, phosphorylated ERK1/2 (p-ERK1/2), translocase of outer mitochondrial membrane 20 (TOM20), translocase of inner mitochondrial membrane 23 (TIM23), B cell lymphoma 2 (Bcl2), and Bcl2 associated X protein (BAX) were detected in cells. Results Overexpression of GalNAc-T4 significantly increased the proliferation activity, the mitochondrial membrane potential, and the expression of TOM20, TIM23, and Bcl2 in H9c2 cells in HG+H/R group, and decreased the cell apoptosis rate, the levels of ROS and iron ion. Meanwhile, it inhibited the mitochondrial autophagy and downregulated the expression of p-ERK1/2/ERK1/2 and BAX in cells. EGF partially reversed the protective effect of the overexpression of GalNAc-T4 on cardiomyocytes, and the differences were statistically significant. Conclusion Overexpression of GalNAc-T4 could significantly improve the mitochondrial dysfunction in H9c2 cells undergoing hypoxia/reoxygenation under high glucose conditions, inhibit oxidative stress and excessive mitochondrial autophagy, and reduce the apoptosis rate of cardiomyocytes. This may be related to its ability to block the activation of ERK1/2 signaling pathway.

PMID:41620966

Alcohol Clin Exp Res (Hoboken). 2026 Feb;50(2):e70225. doi: 10.1111/acer.70225.

ABSTRACT

BACKGROUND: Despite potentially harmful consequences, people routinely encounter alcohol adverts designed to increase consumption of alcohol in preference to safer alternatives. However, individuals differ in the degree to which such adverts elicit preferential alcohol consumption. This study builds upon and extends prior research by testing hypotheses concerning the impact of biased processing during advert viewing on subsequent alcohol craving and consumption.

METHOD: Sixty-eight undergraduate students viewed beer and soft drink adverts. In some viewing blocks, beer and soft drink adverts played simultaneously to assess participants’ attentional bias to beer adverts. In others, participants were asked to choose which type of advert to view, which assessed bias in volitional viewing choice. Participants subsequently rated their craving for beer before completing a taste test designed to yield a behavioral measure of preferential beer consumption.

RESULTS: Attentional bias to alcohol adverts predicted beer craving and preferential beer consumption. The association between attentional bias and preferential beer consumption was mediated by beer craving. An equivalent pattern of prediction was observed when using the viewing choice bias measure as the predictor. Importantly, when variation in either bias measure was statistically controlled for, the other continued to predict preferential beer consumption in a manner that was mediated by beer craving.

CONCLUSIONS: Two types of processing bias during advert viewing-viewing preference and attentional bias-were independently associated with subsequent preferential alcohol consumption. In both cases, these associations were accounted for by alcohol craving. The theoretical and applied implications of this are discussed.

PMID:41620957 | DOI:10.1111/acer.70225

JMIR Med Educ. 2026 Jan 30. doi: 10.2196/83779. Online ahead of print.

ABSTRACT

BACKGROUND: Structured educational programs for physicians in healthy longevity medicine (HLM) remain scarce. No published data yet document the impact of longevity-focused medical education on physicians. This study assesses the ramification of the HLM curriculum, certified by the American Council for Continuing Medical Education (ACCME), on physicians’ confidence in knowledge of HLM and clinical practice.

OBJECTIVE: This study aimed to evaluate the impact of accredited HLM education on physicians’ confidence in knowledge, and practice patterns, examining self-reported integration of HLM principles, professional attitudes, and career trajectories to determine the translational value of structured curricula in the emerging medical discipline.

METHODS: A cross-sectional online survey was conducted between March and April 2024 among physicians who had completed accredited HLM courses between January 2023 and February 2024. Invitations were sent globally to 590 eligible physicians; trainees and students were excluded. A total of 113 respondents completed the survey and were included in the analysis. The survey assessed self-reported changes in clinical implementation, confidence in HLM-related knowledge, and professional attitudes following course completion. Descriptive statistics and logistic regression analyses were performed (p < .05, 95% CIs).

RESULTS: Respondents represented 42 nationalities and were primarily trained in family medicine (27.4%) and internal medicine (15.93%). Overall, 96.5% reported increased confidence in HLM-related knowledge, with 47.8% indicating substantial improvement. More than half (55.8%) reported integrating HLM principles into routine patient assessments, and 80.5% reported more frequent discussions related to healthspan-focused care. Additionally, 23% initiated aging biomarker testing, 48.7% increased testing frequency, 52.2% reported a shift in their perspective on aging, and 73.5% anticipated full integration of HLM into mainstream medicine. Physicians practicing in specialized care demonstrated higher odds of reporting increased confidence in HLM knowledge compared with those in primary and preventive care (OR 4.46, 95% CI 1.55-12.79, p = .005).

CONCLUSIONS: Accredited education in HLM is associated with enhanced confidence in HLM knowledge, increased clinical engagement with HLM practices, and a shift in aging-related care paradigms. These findings underscore the critical role of structured HLM curricula in bridging the translational gap between geroscience and everyday medical practice. Nevertheless, systemic healthcare barriers impede widespread implementation, warranting policy-level strategies to support healthspan-oriented education and care models.

PMID:41620952 | DOI:10.2196/83779

Pak J Pharm Sci. 2026 Mar;39(3):878-886. doi: 10.36721/PJPS.2026.39.3.REG.12881.1.

ABSTRACT

BACKGROUND: Septic shock is a life-threatening complication of sepsis, often accompanied by cardiopulmonary dysfunction, which significantly increases the mortality of patients. Norepinephrine (NE) is a commonly used vasopressor in the treatment of septic shock, but single-drug therapy may not fully achieve cardiopulmonary protection. Antidiuretic hormone (ADH) has potential regulatory effects on hemodynamics and inflammation, but its combined efficacy with NE in cardiopulmonary protection for septic patients remains to be further verified.

OBJECTIVES: This study aims to investigate the effectiveness of ADH combined with NE in providing cardiopulmonary protection for septic patients.

METHODS: A total of 100 patients with septic shock admitted to our hospital from March 2022 to March 2023 were enrolled in this study. They were randomly divided into an observation group and a control group, with 50 patients in each group. The observation group was treated with ADH combined with NE, while the control group received NE monotherapy. Relevant indicators of the two groups were dynamically monitored and compared.

RESULTS: Statistical analysis showed that tumor necrosis factor-α (TNF-α), cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) had significant differences in group effect, time effect, and interaction effect (P<0.05). Interleukin-1 (IL-1) and interleukin-6 (IL-6) only showed significant time effect (P<0.05), but no significant group effect or interaction effect (P>0.05). Arterial partial pressure of oxygen (PaO₂) and PaO2/fraction of inspired oxygen (P/F ratio) exhibited significant time effect and group effect (P<0.05), but no significant interaction effect (P>0.05). After treatment (T3), compared with the control group, the observation group had significantly lower levels of TNF-α, IL-1, IL-6, cTnI, BNP, and creatine kinase isoenzyme MB (CK-MB) (P<0.05), and significantly higher PaO₂ and P/F ratio (P<0.05).

CONCLUSION: ADH combined with NE can effectively improve the inflammatory response, cardiac and pulmonary function indexes of septic patients, and exert significant cardiopulmonary protection effects. It is a viable and effective therapeutic strategy for septic patients.

PMID:41620916 | DOI:10.36721/PJPS.2026.39.3.REG.12881.1

Pak J Pharm Sci. 2026 Mar;39(3):597-603. doi: 10.36721/PJPS.2026.39.3.REG.14269.1.

ABSTRACT

BACKGROUND: Diabetic macular edema (DME) is a predominant cause of visual impairment among patients. The concurrent administration of anti-vascular endothelial growth factor (VEGF) agents and corticosteroids may yield synergistic therapeutic benefits.

OBJECTIVE: In this study, we evaluated the efficacy and safety of aflibercept (AFL) in combination with dexamethasone (DEX) intravitreal implant for the treatment of DME.

METHODS: A total of 80 patients with DME admitted to a hospital from June 2022 to June 2024 were enrolled. 42 patients in the AFL group received monotherapy, and 38 patients in the AFL+DEX group received combination therapy. The best corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and aqueous humor inflammatory factors (IL-1β, MCP-1, IL-6, VEGF) were evaluated monthly. Efficacy was graded according to criteria at 4 months after treatment, and adverse events were recorded.

RESULTS: The findings revealed no statistically significant difference in the overall clinical efficacy rate between the AFL+DEX group and the AFL group (P>0.05). However, the AFL+DEX group demonstrated superior best-corrected visual acuity (BCVA) at 1, 3 and 6 months post-treatment, alongwith a significant reduction in central macular thickness (CMT) compared to the AFL group (P<0.05). Furthermore, aqueous humor analysis indicated markedly lower levels of inflammatory cytokines in the AFL+DEX group following treatment (P<0.05). In terms of safety profiles, the AFL+DEX group required fewer intravitreal injections (P<0.05).

CONCLUSION: These findings underscore the potential of AFL combined with DEX intravitreal implant to enhance visual outcomes and modulate intraocular inflammation in DME patients, highlighting its substantial clinical utility.

PMID:41620889 | DOI:10.36721/PJPS.2026.39.3.REG.14269.1

Wiad Lek. 2025;78(12):2830-2836. doi: 10.36740/WLek/214048.

ABSTRACT

OBJECTIVE: Aim: To identify and analyze the factors that mandate the technologization of iatrogenic crime investigation process and to propose actionable strategies for integrating modern technologies and algorithms into investigative practices for this class of criminal proceedings.

PATIENTS AND METHODS: Materials and Methods: This research is based on an analysis of official WHO documents, 31 relevant judgments from the European Court of Human Rights (ECHR) concerning adverse medical outcomes, 19 verdicts and decisions from Ukrainian courts on medical malpractice, and statistical data from the Prosecutor General’s Office of Ukraine for the period 2016-2021. The primary analysis is supplemented by a review of recent scientific articles from leading academic databases.

CONCLUSION: Conclusions: It has been proven that although patient harm resulting from the provision of low-quality medical care is very widespread worldwide and often becomes the subject of criminal investigation, Ukraine demonstrates a very low level of investigation and detection of iatrogenic crimes. It is proposed that these shortcomings be corrected through technologization, which includes the algorithmization of investigative actions and the application of the latest technologies.

PMID:41620885 | DOI:10.36740/WLek/214048