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

Simulating the spatial distribution of pollutant loads from pig farming using an agent-based modeling approach

This research developed an agent-based model (ABM) for simulating pollutant loads from pig farming. The behavior of farmer agents was captured using concepts from the theory of planned behavior. The ABM has three basic components: the household or farmer agent, the land patches, and global parameters that capture the environmental context. The model was evaluated using a sensitivity analysis and then validated using data from a household survey, which showed that the predictive ability of the model was good. The ABM was then used in three scenarios: a baseline scenario, a positive scenario in which the number of pigs was assumed to remain stable but supporting policies for environmental management were increased, and a negative scenario, which assumed the number of pigs increases but management measures did not improve relative to the baseline. The positive scenario showed reductions in the discharged loads for many sub-basins of the study area while the negative scenario indicated that increased loads will be discharged to the environment. The scenario results suggest that to maintain the development of pig production while ensuring environmental protection for the district, financial, and technical support must be provided to the pig producers. The experience and education level of the farmers were significant factors influencing behaviors related to manure reuse and treatment, so awareness raising through environmental communication is needed in addition to technical measures

Extragalactic Submillimetric Surveys with BLAST

The Balloon-borne Large Aperture Submillimeter Telescope (BLAST) has recently conducted an extragalactic submillimetric survey of the Chandra Deep Field South region of unprecedented size, depth, and angular resolution in three wavebands centered at 250, 350, and 500 µm. BLAST wavelengths are chosen to study the Cosmic Infrared Background near its peak at 200 µm. We find that most of the CIB at these wavelengths is contributed by galaxies detected at 24 µm by the MIPS instrument on Spitzer, and that the source counts distribution shows a population with strongly evolving density and luminosity. These results anticipate what can be expected from the surveys that will be conducted with the SPIRE instrument on the Herschel space observatory

Submillimetre observations of galaxy clusters with the BLAST: the star formation activity in Abell 3112

We present observations at 250, 350 and 500 μm of the nearby galaxy cluster Abell 3112 (z= 0.075) carried out with the Balloon-borne Large Aperture Submillimeter Telescope. Five cluster members are individually detected as bright submillimetre (submm) sources. Their far-infrared spectral energy distributions and optical colours identify them as normal star-forming galaxies of high mass, with globally evolved stellar populations. They all have (B−R) colours of 1.38 ± 0.08, transitional between the blue, active population and the red, evolved galaxies that dominate the cluster core. We stack to estimate the mean submm emission from all cluster members, which is determined to be 16.6 ± 2.5, 6.1 ± 1.9 and 1.5 ± 1.3 mJy at 250, 350 and 500 μm, respectively. Stacking analyses of the submm emission of cluster members reveal trends in the mean far-infrared luminosity with respect to clustercentric radius and KS-band magnitude. We find that a large fraction of submm emission comes from the boundary of the inner, virialized region of the cluster, at clustercentric distances around R500. Stacking also shows that the bulk of the submm emission arises in intermediate-mass galaxies with KS magnitude ∼1 mag fainter than the characteristic magnitude . The results and constraints obtained in this work will provide a useful reference for the forthcoming surveys to be conducted on galaxy clusters by Herschel