Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Feature selection using SVM probabilistic outputs

Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)4232 LNCS782-79

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Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings7 VOLS5284-5286CEMB

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Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings7 VOLS2044-2047CEMB

LA-ICP-MS and EDS characterization of electrode/electrolyte interfaces in IT-SOFCs materials

Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) in combination with SEM is used for the determination of elemental spatial distribution in ceramic multi-layer systems as those found in Intermediate Temperature Solid Oxide Fuel Cells (IT-SOFCs). Because layer sintering occurs at high temperature (usually well over 1000°C), there may be mutual diffusion of ions from one layer to the other, with dramatic consequences on cell performances. In this work, two model materials have been used to test LA-ICP-MS: La0.83Sr0.17Ga0.83Mg0.17O2.83 (LSGM), one of the most promising electrolytes for IT-SOFCs, and La0.8Sr0.2MnO3 (LSM), a highly representative material of perovskites, which are amply used to design electrode materials. A two-layer system screen-printed onto an LSM pellet (LSM-LSGM-LSM pellet) was successively sintered at a typical processing temperature, i.e. 1300 °C, for a short time (1h). Elemental spatial distribution was determined by line profile analyses carried out on fracture surfaces; for comparison SEM-EDS line profiles were tested on the same surface. LA-ICP-MS line profile analysis evidenced that, notwithstanding the relatively low sintering temperature, and short firing time (1 h per sintering), manganese cation diffusion into LSGM is relatively abundant, in agreement with previous literature reports and present EDS results. While line scan EDX analyses are not conclusive as for Ga and Mg diffusion, LA-ICP-MS shows that both ions diffuse across both interfaces, and Ga diffuses even over very long distances into the LSM pellet; on the contrary, only trace amounts of Mg can be found far from the LSGM/LSM interface