Clinicopathologic Characteristics of Multifocal Gastric Adenocarcinoma

BACKGROUNDANDOBJECTIVE: Gastric cancer is the fifth prevalent cancer in worldwide. Among of this, adenocarcinoma is more than 95% of all case and most prevalent. According to gastric adenocarcinoma is resistant to adjuvant therapy, surgical resection is the cardinal strategies of treatment. One of the problems with treating adenocarcinoma of the stomach is that its main causes are malignant or pre-malignant changes in the residual gastric tissue that may be neglected during resection. By recognizing these lesions and resection, they can be expected to reduce the malignancy. Therefore, this study was conducted to investigate the characteristics of non-tumoral gastric tissue in terms of malignant or pre-malignant changes. METHODS: In this retrospective cross-sectional study, 112 patients who had undergone total gastrectomy in the hospitals affiliated to Babol University of Medical Sciences during the period of 2013-2017 were examined and analyzed for age, sex, type and location of tumor. FINDINGS: Of 112 cases that studied,72 cases (64.3%) were male and 40 cases (35.7%) were female. The mean of ages was 64.7±8.6 year. Poorly differentiated pathology in 60.7% and well differentiated pathology in 39.3% of patients were seen. In 64 patients (57%), there was synchronous lesions in addition to primary pathology. These synchronous lesions were related statistically significant to pathology, cancer stage and gender. CONCLUSION: Based on the results of this study, it can be concluded that resection should be accompanied by considering simultaneous lesions in addition to primary pathology, which can be a reason for total gastrectomy as a standard treatment for gastric cancer

Differences in the solar cycle variability of simple and complex active regions during 1996-2018

Aims. Our aim is to examine the solar cycle variability of magnetically simple and complex active region. Methods. We studied simple (alpha and beta) and complex (beta gamma and beta gamma delta) active regions based on the Mount Wilson magnetic classification by applying our newly developed daily approach. We analyzed the daily number of the simple active regions (SARs) and compared that to the abundance of the complex active regions (CARs) over the entire solar cycle 23 and cycle 24 until December 2018. Results. We show that CARs evolve differently over the solar cycle from SARs. The time evolution of SARs and CARs on different hemispheres also shows differences, even though on average their latitudinal distributions are shown to be similar. The time evolution of SARs closely follows that of the sunspot number, and their maximum abundance was observed to occur during the early maximum phase, while that of the CARs was seen roughly two years later. We furthermore found that the peak of CARs was reached before the latitudinal width of the activity band starts to decease. Conclusion. Our results suggest that the active region formation process is a competition between the large-scale dynamo (LSD) and the small-scale dynamo (SSD) near the surface, the former varying cyclically and the latter being independent of the solar cycle. During solar maximum, LSD is dominant, giving a preference to SARs, while during the declining phase the relative role of SSD increases. Therefore, a preference for CARs is seen due to the influence of the SSD on the emerging flux.Peer reviewe

Time-series analysis of long-term photometry of BM Canum Venaticorum

Long-term photometry is commonly used to monitor chromospheric activity of late-type stars. We study standard Johnson differential V photometry of the RS CVn binary BM Canum Venaticorum (BM CVn) spanning over a quarter of a century. Our main aims are to determine the activity cycles, the rate of surface differential rotation, and the rotation period of the active longitudes of BM CVn. The continuous period search (CPS) algorithm is applied to the photometry. The changes of the mean and amplitude of the light curves are used to search for activity cycles. The rotation period changes give an estimate of the rate of surface differential rotation. The Kuiper method is applied to the epochs of the primary and secondary minima to search for active longitudes. The photometry reveals the presence of a stable mean light curve (MLC) connected to the orbital period P-orb=20.(d)6252 of this binary. We remove this MLC from the original V magnitudes, which gives us the corrected V magnitudes. These two samples of Vand Vdata are analyzed separately with CPS. The fraction of unreliable CPS models decreases when the MLC is removed. The same significant activity cycle of approximately 12.5 years is detected in both V and V samples. The estimate for the surface differential rotation coefficient, k >= 0.10, is the same for both samples, but the number of unrealistic period estimates decreases after removing the MLC. The same active longitude period of P-al=20.(d)511 +/- 0.(d)005 is detected in the V and V magnitudes. This long-term regularity in the epochs of primary and secondary minima of the light curves is not caused by the MLC. On the contrary, the MLC hampers the detection of active longitudes.Peer reviewe

Planet Hunters IX. KIC 8462852 - Where\u27s the flux?

Over the duration of the Kepler mission, KIC 8462852 was observed to undergo irregularly shaped, aperiodic dips in flux of up to ~20 per cent. The dipping activity can last for between 5 and 80 d.We characterize the object with high-resolution spectroscopy, spectral energy distribution fitting, radial velocity measurements, high-resolution imaging, and Fourier analyses of the Kepler light curve. We determine that KIC 8462852 is a typical main-sequence F3 V star that exhibits no significant IR excess, and has no very close interacting companions. In this paper, we describe various scenarios to explain the dipping events observed in the Kepler light curve.We confirm that the dipping signals in the data are not caused by any instrumental or data processing artefact, and thus are astrophysical in origin. We construct scenario-independent constraints on the size and location of a body in the system that are needed to reproduce the observations. We deliberate over several assorted stellar and circumstellar astrophysical scenarios, most of which have problems explaining the data in hand. By considering the observational constraints on dust clumps in orbit around a normal main-sequence star, we conclude that the scenario most consistent with the data in hand is the passage of a family of exocomet or planetesimal fragments, all of which are associated with a single previous break-up event, possibly caused by tidal disruption or thermal processing. The minimum total mass associated with these fragments likely exceeds 10-6 M⊕, corresponding to an original rocky body of \u3e100 km in diameter. We discuss the necessity of future observations to help interpret the system

Planet Hunters IX. KIC 8462852-where's the flux?

Over the duration of the Kepler mission, KIC 8462852 was observed to undergo irregularly shaped, aperiodic dips in flux of up to similar to 20 per cent. The dipping activity can last for between 5 and 80 d. We characterize the object with high-resolution spectroscopy, spectral energy distribution fitting, radial velocity measurements, high-resolution imaging, and Fourier analyses of the Kepler light curve. We determine that KIC 8462852 is a typical main-sequence F3 V star that exhibits no significant IR excess, and has no very close interacting companions. In this paper, we describe various scenarios to explain the dipping events observed in the Kepler light curve. We confirm that the dipping signals in the data are not caused by any instrumental or data processing artefact, and thus are astrophysical in origin. We construct scenario-independent constraints on the size and location of a body in the system that are needed to reproduce the observations. We deliberate over several assorted stellar and circumstellar astrophysical scenarios, most of which have problems explaining the data in hand. By considering the observational constraints on dust clumps in orbit around a normal main-sequence star, we conclude that the scenario most consistent with the data in hand is the passage of a family of exocomet or planetesimal fragments, all of which are associated with a single previous break-up event, possibly caused by tidal disruption or thermal processing. The minimum total mass associated with these fragments likely exceeds 10(-6) M-circle plus, corresponding to an original rocky body of > 100 km in diameter. We discuss the necessity of future observations to help interpret the system.Peer reviewe

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0.71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50.2% exceed this threshold for suitability in at least one 5×5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Abstract: Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations