Category: Statistics

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i64-i72. doi: 10.1093/jjco/hyaf019.

ABSTRACT

BACKGROUND: We assessed survival trends and international comparisons of patients with cutaneous melanoma from Japanese regional population-based cancer registries participating in the CONCORD-3 study.

METHODS: Subjects were patients aged 15-99 years diagnosed with cutaneous melanoma during 2000-2014, with follow-up completed either 5 years after diagnosis or through 31 December 2014. Five-year net survival was estimated by morphological type and calendar period of diagnosis, using the Pohar Perme estimator, and age-standardized using the International Cancer Survival Standard weights.

RESULTS: Age-standardized 5-year net survival for cutaneous melanoma remained stable among 4018 eligible subjects as follows: 68.9% during 2000-2004 (862 patients), 68.3% during 2005-2009 (1819 patients), and 69.0% during 2010-2014 (1337 patients). Five-year net survival in 2010-2014 was highest for lentigo maligna melanoma (89.0%, 64 patients, not age-standardized), followed by superficial spreading melanoma (88.4%, 91 patients) and acral lentiginous melanoma (83.7%, 163 patients, not age-standardized). However, survival for malignant melanoma not otherwise specified (68.0%, 1120 patients) and nodular melanoma was lower (56.5%, 58 patients). Five-year net survival for all types of cutaneous melanoma combined during 2010-2014 was lower in Japan (69.0%) and South Korea (59.9%) than in Australia, France, Germany, Italy, UK, Canada and the US (>85.7%).

CONCLUSIONS: International disparities in net survival for cutaneous melanoma may be attributable to differences in the distribution of histological sub-types of melanoma and to variation in the availability and utilization of treatment modalities. Continuous monitoring of cancer survival is crucial for developing effective cancer control strategies.

PMID:41859879 | DOI:10.1093/jjco/hyaf019

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i94-i102. doi: 10.1093/jjco/hyaf165.

ABSTRACT

BACKGROUND: Brain tumors are a serious health issue, and survival is an effective indicator of how the healthcare system manages them. We examined net survival trends for patients diagnosed with a primary brain tumor during 2000-2014 in Japan, using data from 16 regional population-based cancer registries participating in the CONCORD-3 study.

METHODS: We included patients aged 15-99 years, with follow-up completed either 5 years after diagnosis or up to 31 December, 2014. We estimated 5-year net survival by age group and morphological subtype using the Pohar Perme estimator, and age-standardized with International Cancer Survival Standard weights.

RESULTS: Five-year net survival for brain tumors increased from 27.9% for patients diagnosed during 2000-2004 to 46.3% in 2010-2014. During 2010-2014, 5-year net survival for astrocytic tumors was 22.3%, but ~90% for neuronal and mixed neuro-glial tumors, germ cell tumors, and other specified tumors. Five-year net survival reached 62.1% for oligodendroglial and oligoastrocytic tumors.

CONCLUSIONS: Five-year net survival for brain tumors in Japan improved during 2000-2014, with remarkable variations by morphologic type. Survival improved for all age groups, and particularly for younger patients, highlighting the need for enhanced survivorship care. Japan’s focus on comprehensive data collection and supportive care for longer-term survivors remains key for further progress. When comparedinternationally, Japan’s gains sit at the higher end of reported survival ranges, underscoring how robust registry infrastructure and equitable access to care could inform strategies for brain tumor care.

PMID:41859878 | DOI:10.1093/jjco/hyaf165

Int J Gynaecol Obstet. 2026 Mar 20. doi: 10.1002/ijgo.70978. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity increases the risk of obstetric and neonatal complications, and adherence to lifestyle interventions during pregnancy presents a challenge. Patient and public involvement (PPI) in trials may foster a more patient-centered approach, potentially improving compliance with intervention and follow up.

OBJECTIVE: To assess the extent of PPI in systematic reviews (SRs) and meta-analyses (MAs) focused on lifestyle interventions for pregnant women with obesity and its impact on compliance and follow-up rates of included randomized controlled trials (RCTs).

SEARCH STRATEGY: Searches were conducted in PubMed, Scopus, Web of Science, and Embase using terms related to “lifestyle”, “obesity”, and “pregnancy”, along with filters for SRs and MAs.

SELECTION CRITERIA: SRs of RCTs, with or without MAs, published from 2013 to 2024, focusing on lifestyle interventions for pregnant women with obesity (BMI ≥30 [calculated as weight in kilograms divided by the square of height in meters]).

DATA COLLECTION AND ANALYSIS: SR quality was assessed using AMSTAR 2. PPI reporting was evaluated using the GRIPP2 checklist and the ACTIVE framework. Compliance and follow-up rates were compared between RCTs with and without PPI.

MAIN RESULTS: Eleven SRs, 10 with MAs (including 94 RCTs) were included. They were of low quality in 3/11 (27%) and critically low in 8/11 (73%). No SRs reported implementing PPI. Only 6/94 (10%) RCTs reported PPI, 2/29 (7%) directly after the introduction of GRIPP2 (2018) and 4/65 (6%) indirectly before its introduction (P = 0.79). PPI occurred during RCT methodology planning in 2/6 (33%), knowledge translation in 2/6 (33%), or both in 2/6 (33%). Compared with RCTs not reporting PPI (n = 94), the median intervention compliance rate in RCTs reporting PPI (n = 6) was higher (74% versus 68%, P = 0.637), and the follow-up rate was lower (78% versus 89%, P = 0.138), but the difference was not statistically significant. These findings warrant cautious interpretation given the limited number of RCTs reporting PPI.

CONCLUSIONS: PPI remains scarce in both SRs and RCTs evaluating lifestyle interventions in pregnant women with obesity. Future research should integrate and clearly report PPI to strengthen the evaluation of lifestyle interventions in this population.

PMID:41859876 | DOI:10.1002/ijgo.70978

Zoo Biol. 2026 Mar 20. doi: 10.1002/zoo.70064. Online ahead of print.

ABSTRACT

Musth, a hormonally driven state characterized by increased testosterone, aggression, and physiological changes, poses significant management challenges for male Asian elephants (Elephas maximus) in zoos. Immunological castration, a nonsurgical method using anti-GnRH immunotherapeutic (Improvest®), offers a promising tool to suppress musth. This case study documents the behavioral and physiological effects of immunological castration in a 54-year-old male Asian elephant at the Oklahoma City Zoo with chronic musth-related welfare concerns. In June 2024, the elephant received a primary dose of Improvest® followed by four monthly boosters. Behavioral observations, animal care records, and fecal androgen metabolite (FAM) concentrations were monitored from January 2024 through the elephant’s humane euthanasia due to unrelated degenerative joint disease in January 2025. Segmented regression analyses revealed that FAM concentrations and visible musth signs declined within 7 weeks of the first dose of Improvest®. Aggression also decreased significantly following an inflection point around this time. Even though changes in stereotypy, feeding, and recumbency were not statistically significant, some trended toward improved welfare. Notably, active spermatogenesis was observed at necropsy, suggesting that the effects of Improvest® may require longer to fully manifest or may be partially reversible. Although limited by its opportunistic, single-subject design and shortened study period, this case contributes valuable insight into the real-world application of immunological castration in geriatric zoo elephants. Immunological castration may serve as a useful strategy for male elephants with musth-associated health risks, especially those no longer intended for breeding. Continued longitudinal studies are needed to evaluate long-term efficacy, reversibility, and animal-specific responses to Improvest.

PMID:41859869 | DOI:10.1002/zoo.70064

Fam Pract. 2026 Feb 7;43(2):cmag011. doi: 10.1093/fampra/cmag011.

ABSTRACT

BACKGROUND: Long-term treatment with short-acting opioids is not recommended for patients with chronic nonmalignant pain. General practitioners should assess patient’s risk of developing long-term treatment prior to prescribing.

AIM: To identify predictors of long-term opioid treatment among adults with nonmalignant pain initiating treatment with short-acting opioids, focusing on general practice consultations and sociodemographic factors.

METHODS: A national register-based repeated cross-sectional linear probability model was employed. The study population comprises adult, nonmalignant pain patients who initiated short-acting opioid treatment during the first half of 2019, resided continuously in Denmark throughout the study period, and survived 6 months postindex date (N = 133,291).

RESULTS: The risk of developing long-term treatment with short-acting opioids was higher among patients with a higher frequency of remote consultations prior to treatment initiation and among those aged 40-59 or ≥80 years, those residing in the Capital or Zealand Region, those with low income or low educational attainment, those unemployed or retired, and those living alone.

CONCLUSION: Higher frequency of remote consultations prior to treatment initiation and several sociodemographic factors were associated with a higher probability of developing long-term treatment with short-acting opioids. These predictors should be considered when prescribing short-acting opioids to adults with chronic nonmalignant pain.

PMID:41859867 | DOI:10.1093/fampra/cmag011

J Sports Med Phys Fitness. 2026 Mar 20. doi: 10.23736/S0022-4707.26.17619-1. Online ahead of print.

ABSTRACT

BACKGROUND: One year after the Major League Baseball (MLB) pitch clock was implemented, position players saw decreased injury rates. The aim of this study was to see if injury rates in position players decreased two years after the implementation of the MLB pitch clock.

METHODS: Injury data was collected for the 2021, 2022, 2023, and 2024 MLB seasons for position players using the fangraphs.com injury database. The incidence rate ratio was calculated to compare the injury rate for the 2024 season to each of the 2021, 2022, and 2023 seasons. A z-test for proportions was used to determine significance levels.

RESULTS: Comparison of the 2024 season to both the 2022 and 2021 seasons found a statistically significant (P<0.05) decrease in the overall total incidence of injuries, upper extremity injuries, head and neck injuries, and lower extremity injuries. Comparison of the 2024 to the 2023 season also found a decrease in the incidence of injuries for the overall number of injuries (P=0.020) and head and neck injuries (P=0.424).

CONCLUSIONS: This study found a continued decrease in the overall incidence of injuries and a decrease in the incidence of injuries in multiple sub-categories at two-year follow-up since the implementation of the pitch clock. This continued decrease in injuries in position players may stem from a decrease in players’ overall workloads over a season.

PMID:41859841 | DOI:10.23736/S0022-4707.26.17619-1

Euro Surveill. 2026 Mar;31(11). doi: 10.2807/1560-7917.ES.2026.31.11.2600185.

ABSTRACT

In August 2023, 721 individuals became ill with gastrointestinal symptoms in 17 schools in a Finnish municipality. Of these, 323 (45%) developed quickly passing symptoms during school lunch or < 30 min after the lunch. In a questionnaire-based retrospective cohort study, consumption of flour tortillas and vegetable filling served at lunch were statistically associated with illness (adjusted odds ratio (aOR) = 3.3; 95% confidence interval (CI): 1.4-7.4 for the tortillas and aOR = 1.5; 95% CI: 1.1-2.1 for the filling). Abnormal odour was observed in five of nine tortilla samples. In three samples from tortillas produced during a limited production period, high concentrations of calcium propionate (E 282) were measured (> 24,000 mg/kg), exceeding the regulatory maximum limit of 2,000 mg/kg. The tortillas served at lunch were traced to a manufacturer in another EU country. The manufacturer was unable to identify any cause in the production process that could explain the high concentrations of calcium propionate. Our results are in line with findings from other investigations that excessive calcium propionate can induce gastrointestinal symptoms. The investigation highlights the need for strengthened surveillance of chemical-related food-borne outbreaks in Europe and timely communication between school staff and public health authorities to support rapid outbreak detection and response.

PMID:41859828 | DOI:10.2807/1560-7917.ES.2026.31.11.2600185

J Ren Care. 2026 Mar;52(1):e70057. doi: 10.1111/jorc.70057.

ABSTRACT

BACKGROUND: Health literacy directly influences quality of life through its impact on treatment adherence and self-care management, making it particularly important to investigate this relationship in resource-limited settings such as Mogadishu.

OBJECTIVE: This study aimed to determine the relationship between health literacy and quality of life among people receiving Haemodialyses.

METHODS: This descriptive and correlational study was conducted between January and March 2024 with 143 individuals undergoing Haemodialyses in Mogadishu, Somalia. The Short-Form Health Literacy Instrument and the Short Form-12 Health Survey were used for data collection.

RESULTS: Male, single, high school-educated participants, those who perceived their health as good, and those who had received dialysis-related education had significantly higher health literacy scores (p < 0.05). High school graduates and self-employed participants had higher physical component scores of the Short Form-12 Health Survey (p < 0.05). Participants with an arteriovenous fistula and those who received dialysis-related education had higher mental component scores (p < 0.05). A significant positive correlation was found between health literacy scores and physical component scores, whereas health literacy was negatively correlated with age (p < 0.05). In addition, physical component scores were negatively correlated with Haemodialyses duration (p < 0.05).

CONCLUSION: Higher health literacy was associated with better quality of life. Sociodemographic characteristics influenced both health literacy and quality of life. Longer duration of Haemodialyses was associated with poorer physical quality of life, whereas receiving dialysis-related education was associated with better mental quality of life.

PMID:41859825 | DOI:10.1111/jorc.70057

Int Health. 2026 Mar 20:ihag027. doi: 10.1093/inthealth/ihag027. Online ahead of print.

ABSTRACT

Lymphatic filariasis is a profoundly neglected tropical disease (NTDs). While global research has largely focused on the prevalence and clinical manifestations of LF; there is a dearth of information, limited attention has been given to the psychosocial dimensions of the condition. This scoping review highlight on the lived experiences and self-reported impacts among people with lymphatic filariasis. Studies were included if published between 2000 and 2025 in a peer-reviewed journal, reported the lived experience, stigma, and self-reported mental health impact, presented a qualitative report, and fell within the healthcare domain. Searches were conducted across five databases. Duplications were removed and data was extracted and synthesized using a pre-designed Microsoft Excel spreadsheet. Seven themes emerged from the included studies: (1) Experiences of diagnosis and disease onset, (2) Emotional and psychological consequences, (3) Stigma, discrimination and social exclusion, (4) Social, family and community dynamics, (5) Economic and occupational impacts, (6) Healthcare access, dynamics and treatment, (7) Expressed needs and desired change. Family and community support were found to improve coping, though such support is inconsistent. Strengthening health systems, enhancing provider training, and implementing public education initiatives are essential to improve diagnosis, reduce stigma, and promote inclusive care for individuals affected by LF.

PMID:41859824 | DOI:10.1093/inthealth/ihag027

Trans R Soc Trop Med Hyg. 2026 Mar 20:trag024. doi: 10.1093/trstmh/trag024. Online ahead of print.

ABSTRACT

BACKGROUND: Q fever is an underrecognised zoonosis with significant global and regional variation. Data on its burden in North India are limited. This study aimed to determine the frequency and clinical profile of Q fever among patients presenting with acute febrile illness in a tertiary care hospital in Kashmir.

METHODS: A hospital-based study was conducted over 18 months in which patients with fever ≤3 weeks were enrolled after excluding other defined infections. Serum and whole blood samples were tested for Coxiella burnetii using enzyme-linked immunosorbent assay (ELISA) for phase I/II immunoglobulin M (IgM) and IgG antibodies and conventional polymerase chain reaction (PCR) targeting the IS1111a gene. Demographic and clinical data were analysed using SPSS version 22.0 and R software, with statistical significance set at p<0.05.

RESULTS: Of 96 patients, 15.6% were positive by ELISA, PCR or both. The highest positivity occurred in the 31-40 y age group (45%; p=0.002). The Ganderbal (35.3%) and Srinagar (18.5%) districts showed the highest prevalence (p=0.043). Significant association was observed with a shorter hospital stay (p<0.001). IgG phase II ELISA demonstrated better sensitivity (50%) than IgM phase II ELISA (25%), while PCR provided early detection.

CONCLUSIONS: A frequency of 15.6% for Q fever was observed, especially in the adult age group. PCR outperformed serological assays in early detection, while IgM phase II ELISA showed poor sensitivity. Strengthened clinical suspicion, enhanced diagnostic capacity and integrated One Health surveillance are essential for effective control.

PMID:41859821 | DOI:10.1093/trstmh/trag024