Objective: To compare the clinical characteristics and prognosis of patients with asthma combined with different types of persistent airflow limitation (PAL). Methods: We prospectively collected the clinical data of 288 asthma patients with PAL treated in the Department of Respiratory Medicine of Beijing Tongren Hospital from January 2020 to December 2024, including 170 males and 118 females, aged (63.30±9.19) years. The patients were divided into the PAL type asthma (PAL-A) group (141 patients) and the asthma-chronic obstructive pulmonary disease overlap (ACO) group (147 patients) based on clinical and imaging characteristics. General demographics, pulmonary function, blood routine tests, and serological results were compared between the two groups. All patients were followed up for 6 to 60 months, and were compared the risk of severe acute exacerbation (SAE) of asthma episodes as well as pneumonia. Statistical analysis was conducted using SPSS 22.0 software. Results: Compared with the PAL-A group, the ACO group had a higher proportion of males,≥1 severe exacerbation of asthma in the last 12 months [61.0%(86/141) vs. 47.6%(70/147), χ2=5.19, P=0.023],≥1 pneumonia in the last 12 months [53.9%(76/141) vs.31.3%(46/147), χ2=15.07, P<0.001], emphysema, hypertension, coronary heart disease, and diabetes, as well as older age and higher smoking index; while the FEV1% predicted, DLCO% predicted, peripheral blood eosinophil percentage, total immunoglobulin E (IgE), fractional exhaled nitric oxide (FeNO), and proportions of allergic rhinitis and nasal polyps were lower. Logistic regression analysis showed that the ACO occurrence was positively correlated with age(OR=1.10, 95%CI: 1.032-1.173), smoking index(OR=1.13, 95%CI: 1.088-1.175), and emphysema(OR=22.62, 95%CI: 7.948-64.388), and negatively correlated with total IgE(OR=1.00, 95%CI: 0.997-1.000), FEV1% predicted(OR=0.96, 95%CI: 0.929-0.996), DLCO% predicted(OR=0.97, 95%CI: 0.933-0.998), and nasal polyps(OR=0.34, 95%CI: 0.115-0.977). Log-rank test results indicated higher risks of SAE (Log-rank χ2=11.08, P<0.001) and pneumonia (Log-rank χ2=30.20, P<0.001) in the ACO group. Cox regression analysis revealed that severe asthma(RR=3.03, 95%CI: 1.606-5.713), impaired FEV1% predicted(RR=0.97, 95%CI: 0.950-0.990), and bronchiectasis in HRCT(RR=2.59, 95%CI: 1.276-5.267) were risk factors for SAE in the PAL-A group, whereas severe asthma(RR=2.00, 95%CI: 1.165-3.435), atopy(RR=1.84, 95%CI: 1.046-3.238), and impaired DLCO% (RR=0.98, 95%CI: 0.960-0.995) predicted were risk factors for SAE in the ACO group; meanwhile,≥1 pneumonia in the last 12 months (RR=4.00, 95%CI: 1.525-10.480)and bronchiectasis in HRCT(RR=6.45, 95%CI: 1.458-28.547) were risk factors for pneumonia in the PAL-A group, whereas severe asthma(RR=3.15, 95%CI: 1.724-5.746),≥1 pneumonia in the last 12 months(RR=4.98, 95%CI: 2.445-10.154) and coronary heart disease history(RR=2.19, 95%CI: 1.186-4.054) were risk factors for pneumonia in the ACO group. Conclusion: Among asthma patients, the clinical characteristics and prognosis vary according to the underlying causes of PAL, highlighting the need for further exploration of individualized treatment strategies.

To assess 2-year biochemical control, radiological progression, late side effects, and survival outcomes following stereotactic body radiotherapy (SBRT) for localized prostate cancer in a multicenter Spanish cohort. A total of 250 patients with localized prostate cancer treated with SBRT across 12 Spanish centers between January 2020 and December 2023 were analyzed. Biochemical recurrence was defined according to the Phoenix criterion (nadir PSA + 2ng/mL). Late genitourinary (GU), gastrointestinal (GI), and sexual adverse events were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Univariate and multivariate analyses were performed to identify factors associated with outcomes. Survival was estimated using the Kaplan-Meier method and the log-rank test (p < 0.05). The median age was 72years (IQR: 65-76), and the median baseline PSA was 6.7ng/mL (5.3-8.7). According to the NCCN classification, 30% of patients were low risk, 67% intermediate (26.8% favorable, 39.6% unfavorable), and 3% high or very high risk. The median prescribed dose was 40Gy in five fractions (36.25-40.0), administered on alternate days. At 2 years, biochemical control was 96.4%, and radiological progression occurred in 2.8% of patients, predominantly nodal. The incidence of grade ≥ 2 late adverse events was 7.6% GU, 1.2% GI, and 14.3% sexual. SBRT for localized prostate cancer offers excellent 2-year biochemical control with low rates of late adverse events, supporting its safety and effectiveness in routine clinical practice for selected patients. A longer follow-up is warranted to fully characterize long-term outcomes.

The presence of a sinus tract in chronic periprosthetic joint infection (PJI) has traditionally been considered a contraindication to single-stage total knee arthroplasty (TKA) revision. However, an increasing number of surgeons are now performing single-stage revisions in this context, despite limited comparative data. This study aimed to evaluate whether single-stage revision outcomes differ between fistulized (TKA/F+) and non-fistulized (TKA/F-) infected TKAs. A retrospective case-control study was conducted at a regional reference centre for bone and joint infections, including all patients who underwent single-stage TKA revision for chronic infection between January 2013 and June 2023, with a minimum two-year follow-up. Patients were grouped according to the presence (TKA/F+) or absence (TKA/F-) of a sinus tract. The primary outcome was infection-free survival. Surgical procedures, antibiotic protocols and follow-up schedules were standardized across both groups. Survival analysis was performed using the Kaplan-Meier method and log-rank test. A total of 285 patients were included: 47 TKA/F+ and 238 TKA/F-. The TKA/F+ group had significantly older patients, higher body mass index (BMI) and American Society of Anesthesiologists (ASA) scores, and more comorbidities. Polymicrobial infections were more frequent in TKA/F+ (57% vs. 22%). Despite these differences, infection-free survival rates were similar: 81.2% (±4.3) in TKA/F+ versus 83.6% (±2.2) in TKA/F-, with no statistically significant difference. Surgical management included extensive debridement, systematic sampling, gentamicin-loaded cement and local flap coverage when needed. Single-stage revision may be effective in patients with a sinus tract when performed within a structured surgical and antibiotic protocol. Some stronger studies are needed to assess whether the presence of a sinus tract should not be considered an absolute contraindication. These findings support broader consideration of single-stage strategies in chronic TKA infections. Level III.

Second Transurethral Resection of Bladder Tumor Can Be Safely Omitted in Selected Patients with T1 Non-muscle-invasive Bladder Cancer: Results from the Prospective HuNIRe Trial.

Background: Limited data inform the outcomes of patients with high-risk neuroblastoma (HR-NBL) who relapse after high-dose chemotherapy, autologous stem cell transplantation (ASCT), and external beam radiotherapy (EBRT). Methods: This is a multi-institutional retrospective study of 84 patients with HR-NBL diagnosed between 1997–2021 with a first recurrence after definitive upfront treatment, including ≥1 ASCT and EBRT. Site(s) of first relapse were defined with relation to a patient’s primary tumor location. Progression-free survival (PFS) and overall survival (OS) outcomes were analyzed using Kaplan–Meier curves and log-rank tests. Cox proportional hazard models were used for univariate and multivariable analyses. Results: Twenty-four patients had local recurrences with or without distant relapses (LR) and 60 had distant relapses only. The LR cohort had higher rates of MYCN amplification (70% vs. 36%, p = 0.016). At relapse, the LR cohort had lower rates of additional radiotherapy (32% vs. 61%, p = 0.029) and higher rates of additional surgery (29% vs. 5%, p = 0.005), with similar rates of chemotherapy for both cohorts. With a median follow-up after first relapse of 1.53 years (range: 0.03–15.82), there were no significant differences in interval PFS and OS between the cohorts. After controlling for age at diagnosis and pattern of recurrence, time to interval relapse ≥ 2 years was a significant predictor of improved OS (HR: 0.50, 95% CI: 0.29–0.85, p = 0.011). Conclusions: Patients with relapsed HR-NBL have poor outcomes with median OS &lt; 2 years. Time to relapse was a significant predictor of OS.

Anastomotic leakage (AL) is a severe complication after esophagogastrostomy, yet the classifications of AL and their associated healing times are poorly understood. This study retrospectively analyzed 117 cases of AL among 2,728 patients who underwent esophagectomy with circular stapled esophagogastric anastomosis at Tianjin Medical University Cancer Institute and Hospital from January 1, 2019, to March 31, 2024. AL cases were categorized into four types based on the direction of leakage (anterior, right, posterior, and left). The differences in healing times among these four types were analyzed using the log-rank test. A multivariable Cox model was used to identify factors associated with healing time. The incidence of AL was 4.3% (117/2728), with a median occurrence time of 9 days (Interquartile Range[IQR]: 5) and a median healing time of 56 days (IQR:64). Single cervical ALs accounted for 17.5%, with significantly shorter healing times compared to intrathoracic leaks (33 days vs. 61 days, p=0.018). Right-sided leaks were the most common (49.6%), while left-sided leaks healed faster than right- and posterior-sided leaks (42 days vs. 63 days vs. 70 days, p<0.05). Body Mass Index (BMI), diabetes, and neoadjuvant therapy did not influence healing time. In 117 AL patients, the occurrence of tracheoesophageal fistula (p=0.004) and the placement of trans-fistula reverse drainage tubes (p=0.002) were associated with healing time. These findings provide valuable insights for clinicians to better understand the mechanisms of AL development and predict the healing times.

Background p120-catenin, COL4A2 and SOX10 are emerging as modulators of glioma pathophysiology and progression. This study aimed to characterize the expression pattern of these markers in glioma tissues with different degrees of malignancy, and tested their prognostic value for the outcome of glioblastoma IDH wild-type (GBM IDH wt ) patients, with an additional focus on potential sex-related differences. Methods All markers were assessed by immunohistochemistry in tissue microarrays prepared from healthy brain (n=38), astrocytoma grade 2 (n=24), astrocytoma grade 3 (n=22), and GBM IDH wt (n=204) samples. Correlation analyses were performed using Spearman’s Rho, and survival analyses (5-year overall survival and 1-year progression-free survival) were performed using Kaplan-Meier curves, log-rank test and multivariate proportional hazard models. Results The levels of p120-catenin significantly increased with the degree of glioma malignancy (p&amp;lt;0.001; Rho=0.599), while the opposite was observed for COL4A2 (p&amp;lt;0.001, Rho=-0.387) and SOX10 (p&amp;lt;0.001; Rho=-0.293). High levels of p120-catenin significantly associated with and predicted the poor overall survival of GBM IDH wt patients (HR = 1.861, CI = 1.303-2.658, p&amp;lt;0.001) both male (HR = 1.709, CI = 1.077-2.713, p=0.023) and female (HR = 2.141, CI = 1.138-4.028, p=0.018). Conversely, low levels of SOX10 associated with and predicted the poor overall survival of GBM IDH wt patients (HR = 1.552, CI = 1.025-2.352, p=0.038). Interestingly, SOX10 was an independent prognostic factor only in female patients (HR = 2.842, CI = 1.241-6.511, p=0.014). Regarding progression-free survival, p120-catenin was a significant prognostic factor in the whole cohort of GBM IDH wt patients (HR = 2.542; CI = 1.499-4.312; p&amp;lt;0.001) and in the male patients (HR = 2.431; CI = 1.222-4.836; p=0.011), while SOX10 did not predict the progression-free survival in any group of patients. For COL4A2, we found no significant associations with the patients’ outcome, irrespective of sex. Conclusions p120-catenin is a potential tumor-promoting factor in glioma, and a prognostic marker in GBM. In contrast, COL4A2 and SOX10 appear to act as tumor suppressors in glioma pathophysiology. SOX10 may additionally be a valuable prognostic marker in female GBM patients.

The epidemiological shift toward non-B non-C hepatocellular carcinoma (NBNC-HCC) highlights the need for identifying prognostic markers in this population. While microvascular invasion (MVI) has been established in hepatitis virus-related HCC (HV-HCC), its role in NBNC-HCC remains unclear. This multicenter retrospective study analyzed 3308 patients with HCC undergoing curative resection (2012-2023). Risk factors for MVI were identified using logistic regression in the overall cohort. From this cohort, 439 patients with NBNC-HCC were stratified based on the MVI status and balanced using propensity score matching (PSM). Cox regression models and Kaplan-Meier analysis with log-rank test were employed to compare recurrence-free survival (RFS) and overall survival (OS) between MVI-positive and MVI-negative subgroups. The incidence of MVI was lower in the NBNC-HCC group compared to the HV-HCC group (31.44% vs. 38.06%, P = 0.007), but viral hepatitis was not an independent risk factor for MVI (OR = 1.20, 95% CI 0.95-1.51, P = 0.118). After PSM, patients with MVI-positive NBNC-HCC had significantly worse RFS (median 30.0 vs. 47.0months) and OS (median 41.0months vs. not reached) compared to MVI-negative patients (both P < 0.01). MVI independently predicted postoperative recurrence (HR = 2.07, 95% CI 1.46-2.94) and mortality (HR = 2.17, 95% CI 1.45-3.26). MVI-positive cases also demonstrated adverse recurrence patterns, characterized by higher rates of simultaneous intrahepatic and extrahepatic recurrence (17.0% vs. 11.4%) and more frequent recurrence beyond the Milan criteria (39.8% vs. 22.9%). MVI independently predicts adverse outcomes in NBNC-HCC, associated with adverse recurrence and reduced survival. The prognostic value of MVI is independent of viral hepatitis, supporting its importance for risk stratification in this population.

This investigation compared all-cause and cause-specific mortality in patients with and without rheumatoid arthritis (RA) in the Veterans Health Administration (VHA) following immune checkpoint inhibitor (ICI) cancer treatment. Veterans with RA and a control set of Veterans without RA who were matched on age, sex, and year of Veterans Affairs enrollment and had received an ICI were identified. All-cause and cause-specific mortality were obtained. Survival from the time of ICI initiation was evaluated using Cox models, Kaplan-Meier curves, and log rank testing. There were 301 patients with RA and 2,114 controls without RA treated with an ICI. The majority of the participants were white, male, and current/former smokers. Lung cancer was the most common malignancy (51.2%), pembrolizumab was the most frequently used ICI (43.9%), and most patients received ICI monotherapy (97.1%). Cox proportional hazard ratio comparison of all-cause mortality in patients with RA to controls without RA was 1.08 (95% confidence interval [CI] 0.94-1.25) for the crude analysis and 1.09 (95% CI 0.94-1.25) for the adjusted analysis. Cause of death was similar in the two groups, most frequently neoplasm in 93.0% and 90.9% for RA and non-RA groups, respectively (P=0.737). Deaths due to infection were rare in both groups (<1.0%). Patients with RA who received ICIs for the treatment of malignancy did not experience increased mortality or differences in cause of death compared with patients without RA receiving ICIs. These preliminary data suggest ICI therapy may be considered as part of cancer treatment in RA patients based on individual patient circumstances.

Biliary complications (BCs) remain a frequent and clinically important cause of morbidity after living donor liver transplantation (LDLT), with adverse effects on graft function and long-term survival. However, evidence from Central Asia remains scarce. To evaluate the incidence, risk factors, and survival impact of BCs in adult LDLT recipients at a Central Asian centre. This retrospective observational cohort study included 205 adult recipients who underwent living donor liver transplantation between 2011 and 2024. Biliary complications were defined based on combined clinical, biochemical, and radiological criteria. Patients were stratified according to biliary anatomy and reconstruction technique. Risk factors for biliary complications were evaluated using logistic regression analysis. Overall survival was assessed using the Kaplan-Meier method and compared between groups using the log-rank test. BCs developed in 50 patients (24.4%). Biliary strictures occurred in 27 patients (54.0%), bile leakage in 15 (30.0%), and combined lesions in 8 (16.0%). Multivariate analysis identified male sex (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.01-4.39; p = 0.045) and multiple bile ducts (OR 2.92, 95% CI 1.33-6.39; p = 0.008) as independent predictors of BCs. Prolonged cold ischaemia time was significant on univariate analysis but not after adjustment. Overall survival at 1, 3, and 5 years in the entire cohort was 85.7%, 81.0%, and 78.0%, respectively. Patients with BCs demonstrated reduced long-term survival compared with the overall transplant cohort, with survival rates of 93.3%, 78.3%, and 73.3% at the corresponding time points. In this Central Asian LDLT cohort, multiple bile ducts and male sex were independent risk factors for biliary complications, which were associated with poorer long-term survival. Careful preoperative biliary evaluation, preservation of ductal blood supply, and tailored reconstruction techniques are critical to reducing biliary morbidity and improving outcomes following LDLT.

China continues to face a substantial burden of gastric cancer (GC), particularly with respect to metastasis-related mortality. However, population-based analyses of distant metastasis patterns in Chinese GC patients remain unavailable. Global Burden of Disease (GBD) data on GC from the 1990 to 2021 period was obtained through the Global Health Data Exchange (GHDx) query tool and integrative data of 18919 patients who underwent surgery were obtained from our hospital. Univariate and multivariate logistic regression identified independent risk factors for metastases, and survival analysis utilized univariate and multivariate Cox regression, Kaplan-Meier method, and log-rank test. Predictive nomograms were assessed using metrics such as the area under the curve (AUC), calibration curves, and decision curve analysis. According to the GBD database, GC demonstrates declining global trends in both incidence and mortality. Nevertheless, China continues to face a substantial GC burden, with progressive annual rises in distant metastasis prevalence and metastasis-related mortality. Clinical characteristics and temporal patterns vary significantly across metastatic types. Furthermore, metastatic profiles exhibit sex-, age-, and stage-specific variations. Univariate and multivariate regression analyses identified independent risk factors for overall GC metastasis and site-specific metastases. The resulting prediction models demonstrated excellent predictive accuracy for metastatic progression. The prognostic nomogram was developed to predict 1-, 5-, and 10-year overall survival (OS) in GC patients, with AUCs of 0.86 (0.84-0.88), 0.87 (0.85-0.89), and 0.80 (0.74-0.85) in the training set, respectively, which showed good discriminative ability. In this study, metastatic spectrums across diverse patient subgroups and temporal patterns of metastasis in GC were investigated. Furthermore, we developed clinical predictive nomograms for various metastatic patterns and OS in GC, which enhance the understanding of metastatic behavior and provide a robust tool for personalized risk assessment and prognosis prediction.

Purpose To estimate the proportion and timing of assistive technology (AT) device delivery during paediatric inpatient rehabilitation and identify factors associated with delivery rates. Materials and methods We conducted a retrospective cohort study at a neurorehabilitation centre in Argentina, including patients <22 years with hospital stays >20 days, discharged between January and December 2024, and with at least one mobility- or participation-related AT prescription. The primary outcome was time from prescription to documented delivery during hospitalisation. Delivery probabilities were estimated with Kaplan–Meier curves and compared using the log-rank test. Factors associated with delivery were analysed with multivariate Cox regression, with clustered standard errors by patient. Results Thirty-three patients were included (mean age 10.6 years; 39.4% female). Sixty devices were prescribed; 41 (68.3%) were delivered during the inpatient stay. Median delivery time after prescription was 27 days (IQR 10–64). Cumulative delivery probabilities at 30, 60, and 90 days were 45%, 64.3%, and 72.8%, respectively. In the multivariate model, postural or self-propelled wheelchairs had a lower delivery rate than other devices (adjusted HR 0.32, 95% CI 0.12–0.86; p = 0.02). Devices processed through provincial public health insurance were delivered more slowly compared with social security, private coverage, or out-of-pocket payment (adjusted HR 0.41, 95% CI 0.22–0.76; p < 0.01). No significant associations were observed for prescription timing or clinical priority classification. Conclusion Nearly one-third of prescribed AT devices for mobility and participation were not delivered before discharge, and delivery times were often prolonged, particularly for wheelchairs and devices processed through provincial public insurance.

To evaluate clinical outcomes of conjunctival flap surgery in the management of refractory infectious keratitis at a tertiary care center. This retrospective, single-center case series included patients who underwent complete or partial conjunctival flaps for infectious keratitis at the Bascom Palmer Eye Institute between January 2015 and March 2023. Cases were identified via Current Procedural Terminology codes and confirmed by chart review. Surgical success was defined as infection resolution without further surgery or ongoing antimicrobial therapy. Independent samples t tests and χ2 tests compared continuous and categorical variables, respectively. Kaplan-Meier survival analysis evaluated time to resolution, with group differences assessed using log-rank and generalized Wilcoxon tests. Nine patients (43%) received complete flaps, and 12 (57%) received partial flaps. Surgical success was achieved in 55.6% of complete flaps and 66.7% of partial flaps. Larger ulcer area was associated with flap failure (P = 0.021). Best-corrected visual acuity at last follow-up was better (P = 0.043) among partial flap cases (1.7 ± 1.0 logMAR) compared with those of complete flaps (2.7 ± 0.7 logMAR). Kaplan-Meier survival analysis showed that time to resolution differed by flap type according to the Wilcoxon test (P = 0.029) and a trend toward significance by the log-rank test (P = 0.053), suggesting earlier resolution among partial flap cases. Conjunctival flaps achieved infection resolution in most cases of refractory infectious keratitis, with partial flaps showing slightly higher overall success and earlier resolution. These findings support conjunctival flaps as a salvage option, particularly in resource-limited or refractory settings, although further prospective evaluation is warranted.

Sepsis is a critical determinant of mortality in critical patients. Antithrombin (AT) plays a pivotal role as a serine protease inhibitor with dual anticoagulant and anti-inflammatory functions, yet its precise role in prognostic stratification remains undefined. This study aimed to investigate the association between AT activity and clinical outcomes in sepsis and to identify critical prognostic thresholds. We conducted a retrospective cohort study of 222 septic patients from the MIMIC-IV and MIMIC-III databases. AT activity was measured within the first 24h following sepsis diagnosis, with the primary outcome defined as 28-day all-cause mortality. For preliminary description, AT activity was categorized into tertiles. The primary analysis utilized restricted cubic splines (RCS) to model the dose-response relationship and identify risk thresholds. Multivariable Cox regression models were employed to adjust for demographics, comorbidities, and SOFA score. Subgroup and survival analyses were performed to evaluate effect modification and visualize outcome differences across threshold-defined risk groups. To visually compare survival outcomes between patient groups defined by the RCS-derived risk thresholds, we generated Kaplan-Meier curves and employed log-rank tests. A non-linear relationship between AT activity and 28-day mortality was identified, with a marked increase in risk observed below approximately 55% in the overall cohort. Patients with AT activity < 55% had significantly higher 28-day mortality (34.2% vs. 14.4%, p = 0.001), ICU mortality (33.3% vs. 9.0%, p < 0.001), and incidences of disseminated intravascular coagulation (DIC) (22.5% vs. 3.6%, p < 0.001) and acute kidney injury (AKI) (78.4% vs. 62.2%, p = 0.013). Subgroup analysis revealed a significant interaction with hypertension. In the hypertensive subgroup, a similarly elevated risk zone was observed below approximately 64% AT activity. Hypertensive patients below this level had markedly increased 28-day mortality (42.3% vs. 9.62%, p < 0.001), ICU mortality (38.5% vs. 5.77%, p < 0.001), and incidences of DIC (19.2% vs. 1.92%, p < 0.001). Reduced AT activity was significantly associated with higher mortality and organ dysfunction in sepsis. Risk thresholds were observed at approximately 55% for the overall cohort and 64% among hypertensive patients. Patients below these levels exhibited significantly increased mortality and higher incidences of DIC and AKI. These findings support AT activity as a prognostic biomarker for risk stratification and highlight its potential to inform future management strategies for high-risk patients.

The introduction of checkpoint inhibitors in immuno-oncology has raised questions about the suitability of the log-rank test as the default primary analysis method in confirmatory studies, particularly when survival curves exhibit non-proportional hazards. The log-rank test, while effective in controlling false positive rates, may lose power in scenarios where survival curves remain similar for extended periods before diverging. To address this, various weighted versions of the log-rank test have been proposed, including the "MaxCombo" test, which combines multiple weighted log-rank statistics to enhance power across a range of alternative hypotheses. Despite its potential, the MaxCombo test has seen limited adoption, possibly owing to its proneness to produce counterintuitive results insituations where the hazard functions on the two arms cross. In response, the modestly weighted log-rank test was developed to provide a balanced approach, giving greater weight to later event times while avoiding undue influence from early detrimental effects. However, this test also faces limitations, particularly if the possibility of early separation of survival curves cannot be ruled out a priori. We propose a novel test statistic that integrates the strengths of the standard log-rank test, the modestly weighted log-rank test, and the MaxCombo test. By considering the maximum of the standard log-rank statistic and a modestly weighted log-rank statistic, the new test aims to maintain power under delayed effect scenarios while minimizing power loss relative to the log-rank test in worst-case scenarios. Simulation studies and a case study demonstrate the efficiency and robustness of this approach, highlighting its potential as a robust alternative for primary analysis in immuno-oncology trials.

Investigation of mismatch repair protein expression in glioma.

Impact of immunotherapy on outcomes of cutaneous melanoma and concurrent brain metastasis: a surveillance, epidemiology, and end results analysis of 2010-2020.

Anatomical sublobar resection (ASR) is non-inferior to lobectomy for peripheral small-sized lung cancer. However, for nodules located in complex locations, ASR is usually challenging. This study aimed to compare the outcomes of ASR and lobectomy for multi-intersegmental pulmonary nodules. Patients with pulmonary nodules (≤ 2 cm) who underwent ASR or lobectomy between 2012 and 2023 were retrospectively screened. The 3D multiplanar reconstruction software was used to determine the precise tumor localization. Demographic, radiomic, histopathologic, and perioperative characteristics between ASR and lobectomy were compared. The log rank test was adopted for prognostic evaluation. Propensity score-matching (PSM) analysis was conducted to yield matched patients. In total, 93 patients undergoing ASR and 118 subjects undergoing lobectomy were included. Patients with ASR were younger and had a smaller tumor size, fewer solid nodules, and more central nodules than those with lobectomy. ASR achieved a median surgical margin of 2.0 cm, removed fewer lymph nodes, and preserved seven more subsegments than lobectomy (5 vs. 12, p < 0.001), without increasing air leak or postoperative hospital stay. During a median follow-up of 32 months, four patients in the lobectomy group encountered tumor recurrence, whereas no recurrence occurred in the ASR group. The 5-year recurrence-free survival (RFS) after lobectomy and ASR was 95.4% and 100%, respectively. After PSM, 34 matched patients remained in each group, and the RFS was 100% in both groups. ASR is feasible for multi-intersegmental nodules and can preserve more pulmonary parenchyma with no compromise in perioperative and oncological outcomes compared to lobectomy.

Tenofovir alafenamide (TAF) exhibits antiviral efficacy comparable to tenofovir disoproxil fumarate (TDF). Nonetheless, concerns persist regarding TAF's impact on the lipid profile and potential atherosclerotic cardiovascular disease (ASCVD) risk. This study evaluated long-term ASCVD risk in patients with chronic hepatitis B (CHB) treated with TAF or TDF using Korean National Health Insurance Service claims data. We retrospectively analyzed treatment-naïve patients with CHB who received TAF or TDF between 2017 and 2022. Cumulative ASCVD incidence was estimated using the Kaplan-Meier method and compared using the log-rank test. Propensity score (PS) matching and Cox regression were used to minimize confounding and identify ASCVD risk factors, respectively. Among 44,714 patients with CHB, 16,120 (36.1%) received TAF, whereas 28,594 (63.9%) received TDF. Over a median follow-up period of 3.0 years, ASCVD occurred in 817 patients (630 TDF-treated and 187 TAF-treated), with an annual incidence of 6.18/1000 patient-years (PYs). TAF was associated with lower ASCVD risk than TDF (4.60 vs. 6.88/1000 PYs; p < 0.001), a trend maintained after PS matching (4.67 vs. 6.67/1000 PYs; hazard ratio 0.70; p < 0.001) among 15,169 matched pairs. Older age, male sex, hypertension, current smoking, and aspartate aminotransferase ≥ 40 U/L were risk factors for ASCVD development. Despite concerns about lipid metabolism, TAF did not increase ASCVD risk compared with TDF, offering reassurance for clinicians selecting antiviral therapies for patients with CHB.

Validation of FEN-COVID phenotypes in hospitalised COVID-19 patients across the first four waves of the pandemic.