The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Function Approximation Using Haar Wavelets

The generalized approach for function approximation using Haar wavelets is proposed. An approach proposed is based on higher order wavelet expansion and algorithms for determining integration constants. The theoretical study is validated by numerical analysis. The decrease of the absolute error and increase of the numerical rate of convergence with respect to mesh has been observed in comparison with approach available in literature

Experimental Evaluation and Numerical Modelling Residual Stresses in Glass Panel

During last decade increased usage of laminated composite glass structures, also annealed and tempered glass can be observed in civil engineering, automobile and space structures, solar panels, etc. Latter trend is caused by high strength properties of laminated glass, also sound and vibration attenuation capabilities. However, heat treatment of glass causes residual stresses, which are not often covered in structural analysis. Current study is focused on experimental evaluation and numerical modelling of residual stresses in glass panels

Experimental Evaluation and Numerical Modelling Residual Stresses in Glass Panel

During last decade increased usage of laminated composite glass structures, also annealed and tempered glass can be observed in civil engineering, automobile and space structures, solar panels, etc. Latter trend is caused by high strength properties of laminated glass, also sound and vibration attenuation capabilities. However, heat treatment of glass causes residual stresses, which are not often covered in structural analysis. Current study is focused on experimental evaluation and numerical modelling of residual stresses in glass panels

Design and Testing of Sandwich Structures with Different Core Materials

The purpose of this study was to design a light-weight sandwich panel for trailers. Strength calculations and selection of different materials were carried out in order to find a new solution for this specific application. The sandwich materials were fabricated using vacuum infusion technology. The different types of sandwich composite panels were tested in 4-point bending conditions according to ASTM C393/C393M. Virtual testing was performed by use of ANSYS software to simplify the core material selection process and to design the layers. 2D Finite element analysis (FEA) of 4-point bending was made with ANSYS APDL (Classic) software. Data for the FEA was obtained from the tensile tests of glass fiber plastic (GFRP) laminates. Virtual 2D results were compared with real 4-point bending tests.  3D FEA was applied to virtually test the selected sandwich structure in real working conditions. Based on FEA results the Pareto optimality concept has been applied and optimal solutions determined.DOI: http://dx.doi.org/10.5755/j01.ms.18.1.1340</p