https://www.um.edu.mt/library/oar/handle/123456789/696 Wed, 06 May 2026 11:12:13 GMT 2026-05-06T11:12:13Z https://www.um.edu.mt/library/oar/handle/123456789/145718 Title: Progress towards the WHO Global Initiative for Childhood Cancer target of 60% 5-year survival for all childhood cancers combined, 1990–2019 (CONCORD-4) : a Cancer Survival Index derived for 68 countries by analysis of individual records for 613 021 children from 307 population-based cancer registries Authors: Allemani, Claudia; Di Carlo, Veronica; Ssenyonga, Naomi; Khan Baloch, Fatima; Kuehni, Claudia; Girardi, Fabio; Goić, Carolina; Sophiea, Marisa K.; Šekerija, Mario; Espinoza-Vallejos, Carla; Dadouli, Katerina; Sugiyama, Hiromi; Galceran, Jaume; Cañete-Nieto, Adela; Ragusa, Rosalia; Moreno, Florencia; Stiller, Charles; Coleman, Michel P.; Bouzbid, Sabiha; Amarouche, Soumaya; Boussouf, Nadir; Hamdi-Chérif, Mokhtar; Lamia, Kara; Ladipo, Akinade; Ogunbiyi, Olufemi J.; Alcaraz, Claude; Chirpaz, Emmanuel; Somdyala, Nontuthuzelo I.M.; Chaplin, María Agustina; Moreno, Florencia; Rocke, Kern; Sobers, Natasha P.; Alexandre-Moreira, Magna S.; Barros, Herbert C.S.; da Silva, Brenda E.B.; Lima, Carlos A.; Ferreira Ramos Neto, Walmiro; Lima Vazquez, Fabiana; Pena, Gil P.M.; Nativio, Juliana; De Souza, Paulo César F.; Chaves, Juliana; Laporte, Cyntia A.; Daniel, Cristiane B.; de Sousa Reis, Márcia Cristina; do Valle, Karine Meireles; Oliveira, Jose Carlos; Veneziano, Claudia L.A.; Veneziano, Donaldo B.; de Almeida Gil, Roberto; Rebelo, Marise S.; Azevedo e Silva, Gulnar; Armstrong, Heather M.; Quesnel-Crooks, Sarah; Cossani, Gianfranco; Montiel, Alvaro L.; Paz Sandoval, María; Núñez, Kelly G.; Espinoza-Vallejos, Carla; Rosas, Karen; Herrmann, Denise A.; Vargas, Solange M.; Goić, Carolina; Garcia, Christian R.; Cerda, Patricia A.; Hormiga Sánchez, Claudia M.; Uribe, Claudia J.; Cortés Buelvas, Armando D.; Grillo Ardila, Elvia Karina; Arias-Ortiz, Nelson E.; Giraldo-Osorio, Alexandra; Bravo Goyes, Luisa M.; Casas Cruz, Harold M.; Delgado, Sandra; Torres, Adriana; Fernández Garrote, Leticia M.; Galán Alvarez, Yaima H.; Campoverde Arevalo, Nicolas Luciano; Orbe Muñoz, Maria Jose; Jaramillo Feijoo, Leyda Elizabeth; Real Cotto, Jhony Joe; Castillo, Jhoanna M.; Gomez, Anny; González, Juan; Tarupi, Wilmer; Carranza Mena, Monica L.; Fuentes-Alabi, Soad; Drak Alsibai, Kinan; Nacher, Mathieu; Bhakkan, Bernard; Deloumeaux, Jacqueline; Balcarcel, Tatiana; Garrido, Claudia P.; Joachim, Clarisse; Macni, Jonathan; Rivera Gomez, Rebeca; Medina Fernández, Luis E.; Rodriguez Zea, Berenice; Perez, Patricia; Poquioma, Ebert; Ortiz-Ortiz, Karen J.; Torres-Cintrón, Carlos R.; Felix, Nkese S.; Prince-Joseph, Emily; Alonso, Rafael; Musetti, Carina; Eckstrand, Angela; Shack, Lorraine; Simkin, Jonathan; Woods, Ryan R.; Fukumura, Sheila; Turner, Donna; Kumar, Eshwar; Zhang, Bin; Dowden, Jeff J.; Doyle, Gregory P.; Jeffrey, Sarah; Workman, Peter; Saint-Jacques, Nathalie; Walsh, Gordon; De, Prithwish; Norwood, Todd A.; McClure, Carol A.; Phillips, Karen A.M.; Davis, Laci; Kozie, Serena; Freeman, Tara; George, Justin T.; Avila, Rosa M.; Cleaton, Julie; Doyle, Dana; Yee, Georgia; Collins, Lindsay M.; Ramirez Aguilar, Daniela; Almon, Lyn; Kwong, Sandy; Morris, Cyllene; Arend, John; Somma, Valerie; Gonsalves, Lou; Nagarajan, Sumitha; Ross, Wilhelmina; Ruterbusch, Julie; Schwartz, Ann G.; Woods, Alfreda; Lee, David J.; Levin, Gary M.; Bayakly, Rana; Ward, Kevin C.; Lichtensztajn, Daphne; McKinley, Meg; Rees, Judy R.; Shrestha, Anshu; Hernandez, Brenda Y.; Yamamoto, Amy M.M.; Johnson, Christopher J.; Morawski, Bozena M.; Koch, Lori; Aiypkhanova, Ainur; Eisele, Taylor; Bentler, Suzanne; Charlton, Mary E.; Garimella, Sarma; Lai, Sue-Min; Durbin, Eric B.; Huang, Bin; Tucker, Thomas C.; Liu, Lihua; Hsieh, Mei-Chin; Wu, Xiao-Cheng; Bancroft, Carolyn; Hayes, Jennifer H.; Leo, Benjamin R.; Knowlton, Richard C.; Alverson, Georgetta; Weaver, Tamara; Desai, Jay; Highsmith, Mona; Rogers, Deirdre B.; Zachary, Iris; Lemons, Debbi; Zimmerman, Heather J.; Ross, Wilhelmina; Watson, Mark; Ogushi, Aundrea; Reed, Rani; Hammond, Whitney; Rees, Judith R.; Paddock, Lisa E.; Stroup, Antoinette M.; Meisner, Angela W.; Wiggins, Charles; Insaf, Tabassum Z.; Qiao, Baozhen; Rao, Chandrika; Simsek, Fatma; Christina Oancea, S.; Zheng, Yun; Bunt, Emily; Slocumb, Roberta M.; Carter, Meagan; Beran, Todd; Aldinger, Wendy; Oh, Junhie; Janes, Tiffany A.; Schwartz, Stephen M.; Chiodini, Stephanie C.; Kase, Bezawit; Whiteside, Martin A.; Musonda, Keisha L.; Pruitt, Sandi L.; Herget, Kimberly A.; Millar, Morgan M.; Flaherty, Michael; Kachajian, Jennifer; Keitheri Cheteri, Mahesh B.; Migliore Santiago, Patti; Blankenship, Steven E.; Conaway, Jaunita L.; Link Reeve, Jessica; Swander, Lena C.; Espinoza, Julia; Grandpre, Joseph; O’Neil, Mary Elizabeth; Weir, Hannah K.; Wilson, Reda; Mariotto, Angela; Bhakta, Nickhill H.; Rodriguez-Galindo, Carlos; Ong, Sokking; Leong, Elvynna; Chen, Wan-Qing; Wei, Wenqiang; Demetriou, Anna V.; Kazanjan, Konstantine; Mathur, Prashant; Agustina, Julyanti; Khairina, Desy; Keinan-Boker, Lital; Silverman, Barbara G.; Ito, Hidemi; Koyanagi, Yuriko; Sato, Masako; Tobori, Fumio; Matsuzaka, Masashi; Tanaka, Rina; Hippo, Yoshitaka; Michihata, Nobuaki; Teramoto, Norihiro; Yamashita, Natsumi; Hattori, Masakazu; Kaizaki, Yasuharu; Kumagai, Hiroshi; Nakashima, Junichi; Moki, Fumitaka; Oda, Takashi; Sugiyama, Hiromi; Maruyama, Satoru; Todo, Nobuki; Nishimura, Makiko; Yoshida, Keiichi; Kurosawa, Katsuki; Nemoto, Yuji; Narimatsu, Hiroto; Watanabe, Kaname; Kawamura, Chieko; Koduka, Yuji; Kanemura, Seiki; Yoshida, Masayoshi; Kobayashi, Masaaki; Naito, Michiko; Miyashiro, Isao; Nakata, Kayo; Mori, Daisuke; Yoshitake, Mayuko; Nakabayashi, Narue; Tamura, Kenji; Fujita, Shin; Oki, Izumi; Kinjo, Aya; Osaki, Yoneatsu; Fukushima, Norimasa; Shibata, Akiko; Iwasa, Keiichiro; Ono, Chie; Matsuda, Tomohiro; Alawadhi, Eiman; Elbasmi, Amani; Nansalmaa, Erdenekhuu; Tudev, Undarmaa; Ochir, Chimedsuren; Al Khater, Al Hareth M.; El Mistiri, Mufid M.; Alkhalawi, Eman; Al Asiri, Mushabbab A.; Cai, Mingshi; Li Foo, Ling; Jung, Kyu-Won; Park, Eun-Hye; Chiang, Chun-Ju; Lee, Wen-Chung; Harnprakopsuk, Chirapong; Maneesai, Puttachart; Santong, Chalongpon; Daoprasert, Karnchana; Pongnikorn, Donsuk; Leklob, Atit; Sangkitipaiboon, Somphob; Geater, Sarayut L.; Toh, Chanavee; Boztaş, Güledal; Ceylan, Okan; Aksoy, Gülşen; Karakilinç, Hülya; Çidan, Rabia; Kahraman, Ayşe; Gurbuz, Tulın; Emine Karaşahin, Füsun; Turhan, Duygu; Karagöz, Nilüfer; Kurnali, Belgin; Bağcı, Derya; Nilgün Keloğlu, Saime; Eser, Sultan; Yakut, Cankut I.; Altinisik, Merve; Cavusoglu, Yasar; Türkköylü, Ayşe; Üçüncü, Nurşen; Hackl, Monika; Ihle, Petra; Borisevich, Marina; Savich, Tatyana; Henau, Kris; Van Eycken, Liesbet; Atanasov, Trayan Y.; Valerianova, Zdravka; Ivanko, Pero; Šekerija, Mario; Mužík, Jan; Zvolský, Miroslav; Friis, Søren; Kønig, Simon M.; Storm, Hans; Kristensen, Sheila; Innos, Kaire; Mägi, Margit; Lacour, Brigitte; Poulalhon, Claire; Arndt, Volker; Hermann, Silke E.; Peters, Frederik; Schultz, Annemarie; Kajueter, Hiltraud; Stang, Andreas; Holleczek, Bernd; Rath, Natalie B.; Garami, Miklos; Jakab, Zsuzsanna; Murray, Deirdre E.; Redaniel, Maria Theresa; Sundseth, Hildrun; Harney, Mary; Galasso, Rocco; Sampietro, Giuseppe; Melis, Massimo; Calì, Camilla; Savoia, Fabio; Ragusa, Rosalia M.; Torrisi, Antonina; Falcini, Fabio; Ravaioli, Alessandra; Taborelli, Martina; Dal Maso, Luigino; Casella, Claudia; Puppo, Antonella; Cozzi, Ilaria; Santelli, Enrica; Ballotari, Paola; Giacomazzi, Erica; Manasse, Sonia; Pompili, Marco; Gervasi, Federico; Russo, Antonio G.; Cavalieri d’Oro, Luca; Rognoni, Magda; Abbate, Rossella; Vitale, Maria Francesca; Pinna, Pasquala; Usala, Mario; Mazzucco, Walter; Vitale, Francesco; Manzoni, Federica; Maule, Milena M.; Migliore, Enrica; Bisceglia, Lucia; Cuccaro, Francesco; Cascone, Giuseppe; Spata, Eugenia; Rashid, Ivan; Valenti Clemente, Santa; Piras, Daniela; Bella, Francesca; Tumino, Rosario; Mian, Michael; Vittadello, Fabio; Candela, Giuseppa; Scuderi, Tiziana; Adalgisa Gentilini, Maria; Mantovani, William; Caldarella, Adele; Manneschi, Gianfranco; Bianconi, Fortunato; Stracci, Fabrizio; Sbaraglia, Marta; Zorzi, Manuel; Vicentini, Massimo; Baltane, Zane; Maurina, Anita; Smailyte, Giedre; Steponaviciene, Laura; Azzopardi, Miriam J.; Calleja, Neville; Geleijnse, Gijs; Siesling, Sabine; Johannesen, Tom B.; Larønningen, Siri; Trojanowski, Maciej; Macek, Paweł; Mierzwa, Tomasz; Rosińska, Agnieszka; Kępska, Kamila; Niewęgłowska, Justyna; Barna, Katarzyna; Kołodziejczyk, Zofia; Sulkowska, Urszula; Owsiak, Danuta; Garbowska, Edyta; Meina, Małgorzata; Motnyk, Marcin; Patro, Anna; Gos, Anna; Sikorska, Karolina; Didkowska, Joanna A.; Wojciechowska, Urszula; Forjaz de Lacerda, Gonçalo; Macedo, João; Berenguer, Pedro; Camacho, Carolina; Oliveira, Joana; Pais, Ana; Bento, Maria José; Rodrigues, Ana Catarina; Lourenço, Antonio; Mayer-da-Silva, Alexandra; Bucurenci, Mihaela S.; Neaga, Alexandra; Bogdanov, Dmitry V.; Valkov, Mikhail Y.; Egorova, Alla; Orlov, Andrey; Pikalova, Lidiya V.; Zhuikova, Lilia D.; Nazarova, Ekaterina; Zadnik, Vesna; Žagar, Tina; Peterle, Alojz; De-La-Cruz, Marta; Lopez-de-Munain, Arantza; Garrido, Montserrat; Vizcaíno, Ana; Sabater, Consol; Alamo Sanz, Rufino; Gutiérrez Meléndez, Pilar; Jiménez Chillarón, Rosario; Navarro, Ana Isabel Marcos M.; Marcos-Gragera, Rafael; Trallero, Jan; Redondo-Sanchez, Daniel; Sánchez Perez, María-José; Palacios-Castaño, María-Isabel; Ramalle-Gómara, Enrique; Aragonés, Nuria; Parra, David; Chirlaque López, Maria Dolores; Sánchez Gil, Antonia; Ardanaz, Eva; Guevara, Marcela; Alfonso-Camos, Pau; Cañete-Nieto, Adela; Carulla, Marià; Galceran, Jaume; Almela, Fernando; Dickman, Paul; Kuehni, Claudia E.; Sommer, Grit; Cavalli, Franco; Lorez, Matthias; Stähelin, Katharina; Broggio, John; Stevens, Sarah; Stiller, Charles; Bennett, Damien; Fitzpatrick, Deirdre; Morrison, David S.; Stanner, Greig; Huws, Dyfed W.; Smits, Stephanie; Grayson, Margaret; Allemani, Claudia; Coleman, Michel P.; Dadouli, Katerina; Di Carlo, Veronica; Espinoza-Vallejos, Carla; Khan Baloch, Fatima; Matz, Melissa; Minicozzi, Pamela; Sanz, Natalia; Sophiea, Marisa K.; Ssenyonga, Naomi; Stephens, Richard; Chalker, Elizabeth; Smith, Mirka; Johnston, Amy; O’Brien, Tracey; You, Hui; Boyd, Rowena; Dugdale, Sarah; Moore, Julie; Philpot, Shoni; Flak, Stephanie; Mead, Karen; Roydhouse, Jessica; Ragaini, Bruna Silva; Evans, Sue M.; Te Marvelde, Luc; Çakan, Hamza; Handley, Karen; Aitken, Joanne; Fowler, Christine; Lewis, Chris; Estève, Jacques; de Oliveira Santos, Marceli Abstract: Background: CONCORD is a global public health programme for long-term surveillance of population-based cancer survival. The first three cycles of this programme focused primarily on adults. In CONCORD-4, for the first time, we also included all cancers in children. The WHO Global Initiative for Childhood Cancer (GICC), published in 2018, set a target for 5-year survival for all childhood cancers combined, worldwide, to reach 60% by 2030. We designed the protocol for CONCORD-4 to assess progress towards this target in as many countries as possible. Methods: We identified population-based cancer registries from the members of the International Association of Cancer Registries and other sources. We invited 513 registries in 101 countries to submit anonymised individual records for all children (aged 0–14 years) living in their territory who were diagnosed with any form of cancer during the 30-year period 1990–2019, or later years. The data included demographic variables, the morphological type and anatomical location of the tumour, and the follow-up for the vital status of each child. We used the data for 2010–19 to construct a set of weights that reflect the global frequency distribution of childhood cancers, by age, sex, and subtype, both for the 12 major groups in the third edition of the International Classification of Childhood Cancer (ICCC-3) and for the six WHO tracer cancers prioritised in the GICC. We estimated 5-year net survival for children diagnosed during 1990–2019 by age, sex, and type of cancer, using the Pohar Perme estimator. We then used the weights to construct a Cancer Survival Index (CSI) as a weighted average of these survival estimates, for each country and each 5-year period during 1990–2019 for the 12 ICCC-3 groups and separately for the six WHO tracer cancers. Findings: We received 679 776 individual records for children diagnosed with cancer during 1990–2022 from 307 population-based cancer registries in 68 countries and territories, 52 with 100% national coverage. We produced two sets of weights, by age, sex, and type of cancer, reflecting the global distribution of cancer in children, both for all childhood cancers and for the six WHO tracer cancers. We restricted survival analyses to 613 021 children diagnosed during 1990–2019. The 5-year CSI for all childhood cancers combined increased in most countries between 1990 and 2019. For children diagnosed during 2015–19, the CSI was more than 80% in most high-income countries, in the range 60–80% in most upper-middle-income countries, and in the range 50–60% in the five participating lower middle-income countries. Interpretation: The new CSI enables quantitative international comparison of trends in survival for all childhood cancers combined and for the six WHO tracer cancers, through a simple three-way standardisation by age, sex and subtype. The CSI should be a useful tool to monitor future trends. In most high-income, upper-middle-income, and lower-middle-income countries participating in CONCORD-4, the all-cancers CSI was either close to or had already passed the GICC target to reach 60% 5-year survival for all childhood cancers combined, worldwide, by 2030. The GICC target therefore may not be ambitious enough. Funding: Cancer Research UK, Institut National du Cancer (France), St Jude Children’s Research Hospital (USA), US National Cancer Institute, and Dell Technologies. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145718 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145693 Title: Diagnostic reference levels in interventional neuroradiology : a scoping review Authors: Grech, Marvin; Zarb, Francis; Grech, Reuben; Calleja, Neville; Bezzina, Paul Abstract: Objectives: To review the literature on diagnostic reference levels (DRLs) in interventional neuroradiology (INR), summarise reported dose values, and examine the methodologies used for their establishment. Materials and methods: A scoping review was conducted using SCOPUS, Web of Science, PubMed, and ProQuest. Studies reporting DRLs for INR diagnostic procedures (cerebral angiography, (CA)) and therapeutic procedures (stroke thrombectomy, (ST); aneurysm coiling, (AC); arteriovenous malformation/fistula (AVM/AVF) embolisation) were included. Extracted data comprised dose metrics, sample size, percentile definition, procedure classification, and statistical approaches used for DRL derivation. Results: Thirty-nine studies reported DRLs for air kerma–area product (PKA), fluoroscopy time (FT), and reference air kerma (RAK). Most studies defined DRLs using the 75th percentile, although variations were observed in percentile selection, procedure grouping, and inclusion criteria. Considerable heterogeneity in sample sizes and data collection methods was identified. Reported DRLs varied widely: for CA, PKA 41–256.65 Gycm², FT 6–20 min, and RAK 289–921 mGy; for ST, PKA 110–225.1 Gycm², FT 30–45 min, and RAK 730–1590 mGy; for AC, PKA 52.1–487.4 Gycm², FT 16–90 min, and RAK 505–4750 mGy; and for AVM/AVF embolisation, PKA 206.4–550 Gycm², FT 59–135 min, and RAK 2350–6000 mGy. Conclusion: DRLs in INR show substantial variability, partly driven by methodological inconsistencies. Greater standardisation of DRL derivation and reporting is needed to support harmonisation and optimisation. Key Points: Question: How does the lack of international consensus on interventional neuroradiology (INR) diagnostic reference levels (DRLs), alongside inconsistent reporting, hinder benchmarking, optimisation, and radiation protection? Findings: DRLs are reported for major INR procedures, but vary widely across studies and procedure types. Clinical relevance: Differences in dose metrics, procedure classification, and data collection hinder comparison and benchmarking between centres. Standardised methods and harmonised reporting are crucial for effective dose optimisation and radiation protection in INR. Consistency in deriving DRLs would enable reliable benchmarking and support future registry-based initiatives. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145693 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145560 Title: Leading public health innovation in high schools across local and global settings Authors: Joshi, Ashish; Jha, Niharika; Geron, Kami; Jeu, Michelle; Granack, Laura; Shular, Stephen; Kumar, Manoj; Kaur, Tejinder; Guleria, Praveen; Kumar, Sanjeev; Calleja, Neville; Ward, Lori; Elmetwally, Ashraf; Alwatban, Noof; Bhatnagar, Megha; Rosário, Rafaela Abstract: Adolescents in the 21st century face numerous preventable public health challenges that extend beyond academics to include physical, mental, and social well-being. Addressing these issues requires schools to integrate public health education into their systems, empowering youth with digital health literacy and interdisciplinary skills such as critical thinking, problem-solving, communication, innovation, and collaboration. To meet this need, the University of Memphis School of Public Health developed the “RE-AIM Public Health IDEAS” model (Research, Entrepreneurship, Analytics, Informatics, and Management), designed to transform innovative ideas into actionable solutions. The initiative promotes Leadership and Educational Advancement among Youth to solve Public Health (LEAP) challenges and is operationalized through the Public Health in Action curriculum. Public Health Clubs were established in high schools across the United States and India; nearly 400 students contributed to approximately 150 health-focused activities aligned with the Sustainable Development Goals. The program fosters social responsibility, normalizes positive health behaviors, and cultivates the next generation of public health ambassadors. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145560 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/143649 Title: Economic burden of poor maternal perinatal mental health : a systematic review Authors: Lynn, Fiona; Bolbocean, Corneliu; Tecirli, Gülcan; Shigdel, Rajesh; Çelik, Yusuf; Çakmak Barsbay, Mehtap; Caparros-Gonzalez, Rafael; van den Akker-van Marle, M. Elske; Sakilah Adnani, Qorinah Estiningtyas; Delimeta, Inesa; Calleja, Neville Abstract: Background Approximately one in five individuals experience poor perinatal mental health, defined as a mental health problem occurring between conception and up to one year after birth. What is unclear is the economic burden of poor perinatal mental health. Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/143649 2025-01-01T00:00:00Z