Tag: statistics

J Alzheimers Dis. 2026 Mar 20:13872877261431845. doi: 10.1177/13872877261431845. Online ahead of print.

ABSTRACT

BackgroundNormal aging is accompanied by cognitive decline and structural changes in the brain, most notably within the hippocampus and amygdala. However, distinguishing these age-related alterations from the earliest signs of neurodegenerative disorders remains challenging.ObjectiveThis study aims to investigate and compare the alteration patterns of hippocampus and amygdala during normal aging and in cases of mild cognitive impairment (MCI) and Alzheimer’s disease (AD), which will provide insights into their distinct structural profiles.MethodsA total of 2195 participants aged 20-90 from three public cohorts (1364 cognitively normal controls, 623 MCI, and 208 AD) were grouped by decade to examine age- and disease-related differences in surface-based morphometry of hippocampus and amygdala. Radial distance, tensor-based morphometry, and multivariate tensor-based morphometry were calculated and combined to generate the Multivariate Morphometry Statistics, which capture both radial and tangential deformations at each vertex. Statistical and deformation analyses were further performed to identify the alteration patterns across 15000 surface vertices between age groups.ResultsIn healthy adults, significant intergroup differences were observed in the hippocampal CA1 and subiculum, as well as in the lateral, basolateral, and accessory basal nuclei of the amygdala. In MCI and AD, additional significant differences were detected in the hippocampal CA2-3 subfield and the central, medial, and cortical nuclei of the amygdala.ConclusionsWe provide a surface-based morphometry map of the hippocampus and amygdala across age groups in normal and pathological aging, revealing distinct morphological patterns that enhance understanding of aging and neurodegeneration.

PMID:41860363 | DOI:10.1177/13872877261431845

J Glob Health. 2026 Mar 20;16:04109. doi: 10.7189/jogh.16.04109.

ABSTRACT

BACKGROUND: The Kyrgyz Republic has recently implemented health programmes to improve the quality of care for mothers, newborns and children. To support these efforts, a three-year World Health Organization (WHO) quality improvement (QI) project aimed to strengthen clinical practices and service delivery. This study was conducted to independently assess the project’s effectiveness and inform policy and programming.

METHODS: Data were collected retrospectively from 18 hospitals: nine that implemented the intervention (IH) and nine control hospitals (CH). Medical records were randomly selected for women in labour, newborns and children hospitalised in 2019, 2021 (pre-QI project), and 2023 (post-QI project).

RESULTS: We reviewed 1707 women’s, 1736 newborns’, and 1593 children’s records. The proportion of women with a planned caesarean section before 39 + 0 weeks of gestation was 44.8% (2021) and 28.3% (2023) in IH, and 53.3% and 50.0%, respectively, in CH. Antibiotic prophylaxis use for caesarean sections was high in both IH and CH. The proportion of newborns breastfed within the first 30 minutes of life in IH was 58.3% (2021), and 50.6% (2023), and in CH 56.6% and 64.1%, respectively. Newborns were unnecessarily prescribed antibiotics in IH (13.7% in 2021, 16.2% in 2023), and in CH (24.2% and 6.1%, respectively). Children were frequently prescribed unnecessary antibiotics both in IH and CH. Children with pneumonia were unnecessarily prescribed corticosteroids both in IH (35.5% in 2019, 54.7% in 2023) and in CH (28.3% in 2019, 50.9% in 2023). The proportion of children with diarrhoea receiving oral rehydration salts (ORS) and zinc increased between the start and the end of the QI project in IH while this was not the case for zinc prescription in CH.

CONCLUSIONS: These results highlight the importance of continuous monitoring and targeted interventions to enhance quality care. Routine clinical audits based on medical record reviews should be institutionalised to support hospital managers in enhancing clinical practices.

PMID:41860341 | DOI:10.7189/jogh.16.04109

J Glob Health. 2026 Mar 20;16:04104. doi: 10.7189/jogh.16.04104.

ABSTRACT

BACKGROUND: Neonatal herpes simplex virus (nHSV) infection, caused by HSV-1 or HSV-2, is a global health concern due to its high mortality and long-term morbidity. In this study, we assessed nHSV global epidemiology, regional variations, and temporal trends.

METHODS: We conducted a systematic review of PubMed, Embase, and national surveillance reports through 12 December 2024, and reported findings in accordance with PRISMA guidelines. We used random-effects meta-analysis to estimate pooled mean outcomes and meta-regression analyses to assess associations, temporal trends, and potential sources of heterogeneity.

RESULTS: We identified 143 relevant publications from three of the six World Health Organization regions, providing 140 nHSV incidence rate measures and 103 proportions of incident nHSV-1 vs. nHSV-2 cases. The global pooled and regional population-weighted mean incidence rate was 8.2 (95% confidence interval (CI) = 5.9-10.7) per 100 000 live births. Incidence rate was highest in the Americas (13.3 cases per 100 000 live births; 95% CI = 9.9-17.2), followed by the European Region (5.2 cases per 100 000 live births; 95% CI = 3.4-7.3) and the Western Pacific Region (2.9 cases per 100 000 live births; 95% CI = 2.2-3.6). Globally, nHSV-1 and nHSV-2 accounted for pooled and weighted means of 47.3% (95% CI = 39.5-55.0) and 52.8% (95% CI = 45.2-60.5) of cases, respectively. The highest nHSV-1 proportion was in the Western Pacific Region (57.7%; 95% CI = 49.2-66.1), while the highest nHSV-2 proportion was in the Region of the Americas (60.5%; 95% CI = 55.8-65.1). Meta-regression analyses showed an annual increase of 3.5% (95% CI = 1.5-5.6) in nHSV incidence rate, alongside a yearly 1.4% (95% CI = 0.9-1.9) increase in the proportion of nHSV-1 cases and a 1.1% (95% CI = 0.6-1.6) decrease in the proportion of nHSV-2 cases.

CONCLUSIONS: nHSV affects approximately one in 10 000 newborns, with regional variations and a rising incidence rate. The increasing dominance of nHSV-1 over nHSV-2 reflects shifting HSV epidemiology.

PMID:41860333 | DOI:10.7189/jogh.16.04104

J Glob Health. 2026 Mar 20;16:04088. doi: 10.7189/jogh.16.04088.

ABSTRACT

BACKGROUND: Antenatal magnesium sulphate reduces the risk of cerebral palsy (CP) for infants born very preterm. While endorsed by the World Health Organization for global implementation in 2015, studies underpinning this recommendation were conducted in high-income countries. Our objective was to systematically gather, organise, and map published research studies on the use of antenatal magnesium sulphate for preterm foetal neuroprotection in low- and middle-income countries (LMICs), and to obtain existing relevant national and international clinical practice guidelines from (or for) LMICs.

METHODS: Following scoping review methods, we searched nine databases and the websites of societies/ministries of health for relevant qualitative or quantitative studies and national or international guidelines, published from 2015, from any LMIC. We screened each publication for inclusion, and two reviewers independently extracted information. Content analysis included narrative summaries and descriptive statistics.

RESULTS: In total, 57 research studies (12 randomised controlled trials) and 25 clinical guidelines were included in the analysis. Most (n = 75) were in English, from lower-middle (n = 45) and upper-middle (n = 31) countries, and published between 2020 and 2025 (n = 60). The most common research scope was effects and/or safety (n = 38). The remaining studies focused on intervention uptake or quality improvement programmes (n = 10), mechanisms of action (n = 5), or regimen comparisons (n = 4). Short-term outcomes were common, and CP was described in only four studies. Regarding clinical guidelines, magnesium sulphate was usually included in general guidelines (n = 24), those published by professional associations (n = 18), or those published by government bodies (n = 6). After categorisation, an upper gestational limit of 32 weeks was most common (n = 18). Treatment regimens varied, commonly including a 4 g intravenous loading dose (n = 12) and a 1 g/h intravenous maintenance dose (n = 11). One in three recommended no specific regimen.

CONCLUSIONS: A sizeable number of heterogeneous studies and clinical guidelines exist, primarily from middle-income countries, regarding magnesium sulphate for neuroprotection. Further context-specific research may include regimen comparisons, impact, and implementation studies, informing future updates to clinical guidelines globally.

REGISTRATION: OSF 10.17605/OSF.IO/ASN67.

PMID:41860331 | DOI:10.7189/jogh.16.04088

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i73-i86. doi: 10.1093/jjco/hyaf114.

ABSTRACT

BACKGROUND: Breast, cervical and ovarian cancers significantly affect young and middle-aged women, both physically and socially. However, relevant comprehensive stratified analyses are limited. Using Japanese data from CONCORD-3, a global cancer survival surveillance program, we analyzed long-term survival trends.

METHODS: Data from 16 Japanese population-based cancer registries were analyzed for women diagnosed aged 15-99 years during 2000-2014 with a tumor originating in the breast, cervix uteri or ovaries. Follow-up was extended to five years post-diagnosis or until December 31st, 2014. In situ tumors and death-certificate-only registrations were excluded. Five-year net survival was estimated with the Pohar Perme estimator by calendar period of diagnosis, morphology and stage, and age-standardized with International Cancer Survival Standard weights.

RESULTS: During 2000-2014, 5-year net survival improved for breast cancer from 85.9% (95% CI, 85.2-86.6%) to 89.4% (88.9-89.9%), for cervical cancer from 67.5% (66.3-68.7%) to 71.4% (70.4-72.3%), and for ovarian cancer from 35.5% (33.8-37.2%) to 46.3% (44.9-47.7%). Five-year survival for tumors diagnosed at a localized stage remained consistently high (>98% for breast cancer and > 90% for cervical cancer). Ovarian cancer survival varied greatly according to morphology.

CONCLUSIONS: Five-year net survival for women with cancers of the breast, cervix, and ovary) in Japan improved during 2000-2014, and remained at a globally high level throughout this period. These gains are probably attributable to earlier detection of breast and cervical cancers and advances in multimodal treatment for all cancers. Survival for distant-stage cervical and ovarian cancers remains a challenge, underscoring the need for enhanced screening and treatment strategies.

PMID:41859890 | DOI:10.1093/jjco/hyaf114

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i103-i115. doi: 10.1093/jjco/hyaf145.

ABSTRACT

BACKGROUND: We aimed at estimating trends in 5-year net survival for myeloid and lymphoid malignancies, by age group and morphological subtype, using data on patients diagnosed during 2000-2014 and registered by 16 Japanese population-based cancer registries participating in the CONCORD-3 study.

METHODS: We analyzed data on adult patients (15-99 years) diagnosed with a myeloid or lymphoid malignancy during 2000-2014 and followed up to December 31, 2014. We estimated 5-year net survival by age group and morphological subtype with the Pohar Perme estimator, and age-standardized the estimates using International Cancer Survival Standard weights.

RESULTS: Significant improvements were observed in five-year net survival for myeloid malignancies among patients aged 15-44 years (from 57.3% in 2000-2004 to 72.3% in 2010-2014) and 45-54 years (from 41.9% to 61.3% over the same period). For lymphoid malignancies, 5-year net survival improved for all ages, but the improvement was less pronounced for older patients. Five-year net survival improved by 10% or more for myeloproliferative neoplasms, classic Hodgkin’s lymphoma, and follicular lymphoma. Moderate improvement was observed for diffuse B-cell lymphoma and acute myeloid leukemia.

CONCLUSIONS: Five-year net survival for patients with hematological malignancies improved throughout 2000-2014 in Japan. The improvement was more pronounced in younger than older patients. Continuous and detailed monitoring of cancer survival trends is crucial for devising effective control strategies for hematological malignancies. [221/250 words].

PMID:41859889 | DOI:10.1093/jjco/hyaf145

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i44-i55. doi: 10.1093/jjco/hyaf020.

ABSTRACT

BACKGROUND: Pancreatic and liver cancers are the 6th and 7th most common cancers in Japan and are major contributors to cancer mortality.

METHODS: We used CONCORD-3 data to estimate survival for primary pancreas and liver cancers, registered in 16 population-based regional cancer registries. Five-year net survival was estimated with the Pohar Perme estimator for three periods (2000-2004, 2005-2009, 2010-2014), adjusted for age using International Cancer Survival Standard weights.

RESULTS: We analysed data on 79 636 patients with pancreatic cancer and 122 792 patients with liver cancer. Carcinoma accounted for 91.4% of pancreatic cancers, and age-standardized 5-year net survival remained poor, from 6.4% (95% CI: 5.9%-6.9%) in 2000-2004 to 8.3% (7.8%-8.7%) in 2010-2014. Five-year net survival for localized disease increased slightly, from 39.3% (33.4%-45.2%) in 2000-2004 to 44.2% (36.8%-51.7%) in 2010-2014. Distant-stage pancreatic cancer survival remained <2% throughout 2000-2014. Hepatocellular carcinoma accounted for 83.7% of liver cancers. Five-year net survival increased from 27.4% (26.8%-28.1%) in 2000-2004 to 33.4% (32.7%-34.0%) in 2010-2014. Five-year net survival for localized liver cancer increased from 38.0% (35.3%-40.7%) in 2000-2004 to 48.8% (46.4%-51.3%) in 2010-2014, while distant-stage survival remained <5% throughout 2000-2014.

CONCLUSIONS: Five-year net survival remained poor for patients with pancreatic cancer in Japan throughout 2000-2014. Survival for liver cancer improved slightly. Early detection and improved diagnostic methods may help in reduce the proportion of patients diagnosed with advanced-stage.

PMID:41859888 | DOI:10.1093/jjco/hyaf020

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i17-i24. doi: 10.1093/jjco/hyaf159.

ABSTRACT

BACKGROUND: We assessed trends and international comparisons of net survival for patients with esophageal cancer using data from Japanese regional population-based cancer registries participating in the CONCORD-3 study.

METHODS: The analysis included 63 631 patients aged 15-99 years diagnosed with esophageal cancer during 2000-14, with follow-up completed either 5 years after diagnosis or by 31 December 2014. Five-year net survival was estimated using the Pohar Perme estimator, by sex, anatomical subsite, calendar period of diagnosis, and extent of disease. Survival estimates were age-standardized using the International Cancer Survival Standard weights.

RESULTS: During 2000-14, the age-standardized 5-year net survival for esophageal cancer improved from 27.7% (95% CI: 26.4%-29.0%) in 2000-04 to 36.0% (34.8%-37.3%) in 2010-14. This increase corresponded with a higher proportion of patients with localized disease. In 2010-14, survival was notably higher among women, at 42.6% (39.7%-45.5%), than among men, at 36.0% (34.8%-37.3%), and among patients aged 45-54 years at 39.7% (35.5%-44.0%), 55-64 years at 38.9% (37.0%-40.8%), and 65-74 years at 39.4% (37.8%-41.1%). Survival remained lower among the oldest patients, aged 75-99 years, at 29.0% (27.0%-31.0%). By anatomical subsite, survival was highest for the “abdominal, or lower third” segment of the esophagus, followed by the “thoracic, or middle third,” while the “cervical, or upper third” showed the lowest survival.

CONCLUSION: Survival for esophageal cancer in Japan has improved, largely attributable to early detection. Variations by sex, age, and subsite were evident. Detailed analyses using population-based registry data will provide evidence to aid the development of effective cancer control strategies.

PMID:41859887 | DOI:10.1093/jjco/hyaf159

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i87-i93. doi: 10.1093/jjco/hyaf021.

ABSTRACT

BACKGROUND: We aimed at assessing 15-year trends in 5-year net survival for men diagnosed with prostate cancer during 2000-2014 and registered by 16 Japanese regional population-based cancer registries included in the CONCORD-3 study.

METHODS: We included data on adult men (15-99 years) diagnosed with prostate cancer during 2000-2014 and followed-up to 31 December 2014. We grouped patients into five age groups (15-54, 55-64, 65-74, 75-84, and 85-99 years) and four morphology groups according to the ICD-O-3 classification (epithelial, neuroendocrine, other specified morphologies, and malignant neoplasm, not otherwise specified). We grouped patients by stage at diagnosis into localized, regional, and advanced disease. We estimated 5-year net survival by age group, morphological subtype and stage using the Pohar Perme estimator, correcting for background mortality. All-ages estimates were standardized with the International Cancer Survival Standard weights.

RESULTS: Age-standardized 5-year net survival increased over time, from 85.9% in 2000-2004 to 93.0% in 2010-2014. Survival was higher than 90% for epithelial tumors, and for localized and regional disease. Five-year net survival for patients with distant metastasis was poor at 47.3% (95% CI. 39.4-55.1%) during 2010-2014.

CONCLUSIONS: The improvement in survival for prostate cancer may be due to the high and increasing proportion of patients with localized disease and with epithelial tumors, for which 5-year survival approaches 100%. A comprehensive analysis of long-term survival over a longer period of time would be essential to investigate further the factors contributing to the increasing trend in survival.

PMID:41859886 | DOI:10.1093/jjco/hyaf021

Jpn J Clin Oncol. 2026 Mar 20;56(Supplement_1):i116-i125. doi: 10.1093/jjco/hyaf143.

ABSTRACT

BACKGROUND: We assessed survival trends for children with brain tumors, acute lymphoblastic leukemia (ALL), and lymphomas from 16 Japanese regional population-based cancer registries participating in CONCORD-3.

METHODS: We analyzed data for children (0-14 years) diagnosed with a brain tumor, ALL, or lymphoma during 2000-14, with follow-up for at least 5 years after diagnosis or through 31 December 2014. Five-year net survival was estimated by calendar period of diagnosis, age group, and morphology group (for brain tumors), using the Pohar Perme estimator, and age standardized by assigning equal weights to the three age-specific estimates (0-4, 5-9, 10-14 years).

RESULTS: Data on children with a brain tumor (n = 1293), ALL (1438), or lymphoma (508) were eligible. During 2010-14, age-standardized 5-year net survival was 69.6% for brain tumors, 87.6% for ALL, and 89.6% for lymphomas. Survival for ALL was 79.7% in 2000-4, and 87.6% in 2010-14. There were no notable trends for brain tumors or lymphomas. Point estimates of survival for these three childhood cancers in Japan were lower than in several of the Western countries that participated in CONCORD-3.

CONCLUSIONS: The improved survival for ALL probably reflects improved treatment, whereas the lack of improvement for brain tumors may reflect the difficulty in developing more effective treatment strategies for these aggressive tumors. Treatment for lymphomas was established in the 2000s. To evaluate cancer care for children in Japan, we need to continue to monitor survival, using population-based cancer registry data.

PMID:41859885 | DOI:10.1093/jjco/hyaf143