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

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Alternative renewable.

The goal of this project is to determine, based on statistics, the most promising alternative energy sources which soon are going to replace the current fossil fuels. Statistics regarding the reliability, cost-effectiveness, and environmental impact were gathered for each type of energy sources. Based on the data analyzed, solar energy was determined to be the best replacement for fossil fuels

Chip Recycling: Recycling of Chips from BZZ Conditioning Processes

This project, done in conjunction with Saint-Gobain Abrasives, responds to the rising cost of nickel and chromium, the major components of stainless steel by conducting a comprehensive cost analysis of the stainless steel production and recycling processes. Background research was performed with company surveys for important information about specific machines which recycle stainless steel chips. With these data, conclusions were prepared about the cost-effectiveness of recycling as opposed to selling or dumping the stainless steel chips. A cost structure analysis and new recycling methods for specific applications were proposed

Scheduling and power control for connectivity enhancement in multi-hop I2V/V2V networks

Infrastructure-to-vehicle (I2V) and vehicle-to-vehicle (V2V) communications are often combined to extend the connectivity and coverage in the Intelligent Transportation System (ITS) and its applications, e.g., augmented reality, real-time parking management and online shopping. Through multi-hop I2V and V2V communications, requesting vehicles are always connected to road side units (RSUs) even when they do not reside within the RSUs' coverage range. However, there may be not adequate network resource for several I2V and V2V links when multiple vehicles request services simultaneously. In this paper, we propose a joint frequency scheduling and power control scheme to enhance connectivity in multi-hop I2V/V2V networks. We associate I2V and V2V links with tuple-links, then formulate an NP-hard problem in which a frequency scheduler and a power controller are jointly designed for the tuple-links. The NP-hard problem is decomposed into two separate subproblems by employing the delayed column generation technique. Then, we employ a method for linear programming and a greedy algorithm to address these subproblems. Through numerical experiments with practical parameter settings, we demonstrate the proposed scheme outperforms several existing ones in terms of connectivity enhancement, measured by the service resumption number and average achieved throughput. Furthermore, the efficiency of our scheme is further enhanced when the number of available channels is high, and buffer size equipped to the requesting vehicles is large. © 2000-2011 IEEE

Transforming medical education to strengthen the health professional training in Viet Nam: A case study

The competency-based undergraduate curriculum reform at the University of Medicine and Pharmacy at Ho Chi Minh City, Faculty of Medicine (UMP-FM) is detailed and reviewed in reference to the instructional and institutional reforms, and enabling actions recommended by the Lancet 2010 Commission for Health Professional Education. Key objectives are to: revise the overall 6-year curriculum to be more integrated and competency-based; reinforce students’ knowledge application, problem-solving, clinical competence, self-directed learning and soft skills; develop a comprehensive and performance-based student assessment programme; and establish a comprehensive quality monitoring programme to facilitate changes and improvements. New features include early introduction to the practice of medicine, family- and community-based medicine, professionalism, interprofessional education, electives experiences, and a scholarly project. Institutional reform introduces a faculty development programme, joint planning mechanism, a “culture of critical inquiry”, and a transparent faculty reward system. Lessons learnt from the curriculum reform at UMP-FM could be helpful to medical schools from low- and middle-income countries considering transitioning from a traditional to a competency-based curriculum