45 research outputs found
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
Purkinje cell death: Differences between developmental cell death and neurodegenerative death in mutant mice.
This review is devoted to Purkinje cell death occurring during development and in spontaneous cerebellar mutations of the mouse. We first present evidence in favor of an apoptotic developmental Purkinje cell death. Then, the different types of Purkinje cell degeneration occurring in mutant mice primarily affecting this neuronal population (nervous, purkinje cell degeneration, Lurcher, toppler, and woozy) are described and discussed. In addition, we show, by reporting new data, that cell death in tambaleante mutant mice can be related to autophagy. Last, we discuss the fact that the cell death pathways in mutant mice are more complex than the three types of developmental death generally described (apoptosis, autophagy, necrosis), since they share often characteristics of more than one type of these developmental cell deaths, particularly autophagy and apoptosis
Rate constant determination of ozone‐organic fast reactions in water using an agitated cell
The Use of Surface Renewal and Eddy Diffusivity Theories in the Ozonation of a THM Precursor: 1,3-Cyclohexanedione
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
The influence of structure and acidity of zeolitic materials on the transalkylation of diisopropylbenzene with benzene in supercritical carbon dioxide
Enhancing the accuracy of rational function-based models using optimization
Rational function approximations are widely used for the modelling of frequency-dependent effects in power system components. This paper proposes to use optimization by the damped Gauss-Newton method to improve the accuracy of rational approximations calculated by three mainstream fitting techniques: Bode's asymptotic approximation, Sanathanan-Koerner iteration, and vector fitting. The optimization method is described in detail along with an outline of the numerical implementation. The proposed methodology is demonstrated for a synthetic example for the modelling of a measured reactor frequency response and for the rational fitting of the frequency-dependent parameters corresponding to a single-phase transmission line. In this example, we also present the impact of the optimization enhancement on the final time domain responses. ©2015 Elsevier B.V. All rights reserved