Summary Background EUROCARE is the largest population-based cooperative study on survival of patients with cancer. The EUROCARE project aims to regularly monitor, analyse, and explain survival trends ...and between-country differences in survival. This report (EUROCARE-4) presents survival data for eight selected cancer sites and for all cancers combined, diagnosed in adult (aged ≥15 years) Europeans in 1995–99 and followed up until the end of 2003. Methods We analysed data from 83 cancer registries in 23 European countries on 2 699 086 adult cancer cases that were diagnosed in 1995–99 and followed up to December, 2003. We calculated country-specific and mean-weighted age-adjusted 5-year relative survival for eight major cancers. Additionally, case-mix-adjusted 5-year survival for all cancers combined was calculated by countries ranked by total national expenditure on health (TNEH). Changes to survival were analysed relative to cases diagnosed in 1990–94. Findings Mean age-adjusted 5-year relative survival for colorectal (53·8% 95% CI 53·3–54·1), lung (12·3% 12·1–12·5), breast (78·9% 78·6–79·2), prostate (75·7% 75·2–76·2), and ovarian (36·3% 35·7–37·0) cancer was highest in Nordic countries (except Denmark) and central Europe, intermediate in southern Europe, lower in the UK and Ireland, and worst in eastern Europe. Survival for melanoma (81·6% 81·0–82·3), cancer of the testis (94·2% 93·4–95·0), and Hodgkin's disease (80·0% 79·0–81·0) varied little with geography. All-cancer survival correlated with TNEH for most countries. Denmark and UK had lower all-cancer survival than countries with similar TNEH; Finland had high all-cancer survival, but moderate TNEH. Survival increased and intercountry survival differences narrowed between the data for 1990–94 and 1995–99 for, notably, Hodgkin's disease (range 66·1–82·9 IQR 72·2–78·6 vs 74·0–83·9 78·6–81·9), colorectal (29·4–56·7 45·8–54·1 vs 38·8–59·7 50·7–57·5), and breast (61·7–82·7 72·3–78·3 vs 69·3–87·6 76·6–82·7) sites. Interpretation Increases in survival and decreases in geographic differences over time, which are mainly due to improvements in health-care services in countries with poor survival, might indicate better cancer care. Wealthy countries with high TNEH generally had good cancer outcomes, but those with conspicuously worse outcomes than those with similar TNEH might not be allocating health resources efficiently.
The aim of this review was an update of vulvar cancer incidence rates and trends and of all known and putative risk factors for the disease. The most recent incidence data were sought from official ...sources (WHO
). To obtain an estimate of time trends in some areas, we compared data from
with the few available studies that measured incidence using comparable methods. With respect to risk factors, a systematic PubMed search identified 1585 relevant articles published between 1980 and 2021. Abstracts and full texts were screened. Sixty-nine eligible original cohort and case-control studies were selected. Information was extracted using a PRISMA predesigned form. Nineteen risk factors, or risk factor categories, were investigated by two or more original studies. Solitary, unreplicated studies addressed the putative role of eight more factors. Recent advances have provided further evidence supporting the carcinogenic model centred on human papillomavirus infection with different defects of the immune function. Conversely, the model centred on the role of vulvar lichen sclerosus and the often associated differentiated vulvar intraepithelial neoplasia has continued to be epidemiologically understudied. More research on the association between these two conditions and vulvar cancer is a priority.
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•Fatigue strength was found insensitive to the build relative to scraper direction.•Fatigue strength is highly sensitive to porosity morphology, size and distribution.•In most cases, ...lack of fusion was the killer defect.
Additive manufacturing is an emerging technique that is not only subjected to the interest of academic world because of its peculiar characteristics to obtain new material properties and optimized 3D geometries, but it also finds the interest of the industrial sector because of the possibility to build advanced components never realized until now. Among the additive manufacturing processes, Laser Powder Bed Fusion process is perhaps the most used in producing components out of metallic materials. In particular, thanks to its low density and its hypoeutectic favourable composition, AlSi10Mg alloy is particular suitable for the production of lightweight components by additive manufacturing. However, for safety reasons, their mechanical, static and cyclic, characteristics need to be well understood and predicted. Unfortunately, they are dramatically influenced by process parameters that in turn may promote killer defects dangerous for the fatigue strength of load bearing mechanical components. This contribution is aimed at highlighting the influence of defects on the fatigue resistance of AlSi10Mg samples produced by laser powder bed fusion. The combination of process parameters were obtained that maximizes the fatigue strength and reduces the scattering of the results.
Purpose: To compare the flexural properties and the adhesion of Lactobacillus salivarius (LS), Streptococcus mutans (SM), and Candida albicans (CA) on heat-polymerized (CV), CAD-CAM milled (CAD), or ...3D-printed (3D) Poly (methylmethacrylate) (PMMA).Methods: Ultimate Flexural Strength (UFS), Flexural Strain (FS) (%) at Flexural Strength, and Flexural Modulus (FM) of specimens (65.0×10.0×3.3 mm) from each PMMA group (n=6) were calculated by using the 3-point bending test. The surface roughness profiles (R) were measured before and after polishing with a contact profilometer. LS, SM, and CA adhesion on PMMA specimens (n=18) (10 mm in diameter, 3 mm in height) was assessed after 90 minutes and 16 hours by using scanning electron microscopy. The Kruskal-Wallis test with post hoc analysis was performed to compare the groups (alpha=0.05).Results: Mean UFS values were 80.79±7.64 MPa for CV, 110.23±5.03 MPa for CAD, and 87.34±6.39 MPa for 3D. Mean FS values were 4.37±1.04% for CV, 4.71±0.62% for CAD, and 6.19±0.13 % for 3D. Mean FM values were 2542±301 MPa for CV, 3435±346 MPa for CAD, and 2371±197 MPa for 3D. CAD had the lowest average R value (0.29±0.16 µm) before polishing, and bacterial adhesion after 90 minutes of incubation. R value and microbial adhesion were not different amongst groups after polishing and 16 hours of incubation, respectively.Conclusion: The CAD group displayed the best flexural properties, except for FS, the lowest roughness before polishing and bacterial adhesion after 90 minutes of incubation. All tested PMMAs had similar surface roughness after polishing, and microbial adhesion after 16 hours of incubation.
Advances in additive manufacturing technologies facilitate the fabrication of cellular materials that have tailored functional characteristics. The application of solid freeform fabrication ...techniques is especially exploited in designing scaffolds for tissue engineering. In this review, firstly, a classification of cellular materials from a geometric point of view is proposed; then, the main approaches on geometric modeling of cellular materials are discussed. Finally, an investigation on porous scaffolds fabricated by additive manufacturing technologies is pointed out. Perspectives in geometric modeling of scaffolds for tissue engineering are also proposed.
Although most hospital-based studies suggest more favorable survival with tumor-infiltrating lymphocytes (TILs) present in primary melanomas, it is uncertain whether TILs provide prognostic ...information beyond existing melanoma staging definitions. We addressed the issue in an international population-based study of patients with single and multiple primary melanomas.
On the basis of the Genes, Environment and Melanoma (GEM) study, we conducted follow-up of 2,845 patients diagnosed from 1998 to 2003 with 3,330 invasive primary melanomas centrally reviewed for TIL grade (absent, nonbrisk, or brisk). The odds of TIL grades associated with clinicopathologic features and survival by TIL grade were examined.
Independent predictors (P < .05) for nonbrisk TIL grade were site, histologic subtype, and Breslow thickness, and for brisk TIL grade, they were age, site, Breslow thickness, and radial growth phase. Nonbrisk and brisk TIL grades were each associated with lower American Joint Committee on Cancer (AJCC) tumor stage compared with TIL absence (P(trend) < .001). Death as a result of melanoma was 30% less with nonbrisk TIL grade (hazard ratio HR, 0.7; 95% CI, 0.5 to 1.0) and 50% less with brisk TIL grade (HR, 0.5; 95% CI, 0.3 to 0.9) relative to TIL absence, adjusted for age, sex, site, and AJCC tumor stage.
At the population level, higher TIL grade of primary melanoma is associated with a lower risk of death as a result of melanoma independently of tumor characteristics currently used for AJCC tumor stage. We conclude that TIL grade deserves further prospective investigation to determine whether it should be included in future AJCC staging revisions.
The aim was to estimate the risk of subsequent extra-cervical Human Papillomavirus (HPV) related cancer in patients surgically treated for high grade cervical intraepithelial neoplasia (CIN 2-3). ...This is the first study in Italy investigating the occurrence of extra-cervical tumors in this cohort of patients.
3184 patients surgically treated for CIN2-3 since 1992 at the Department of Surgical Sciences of University of Torino were considered. The risk of HPV-related cancer was calculated as Standardized Incidence Ratio (SIR), using as expected values tumour age specific incidence of resident population.
173 second primary cancer (SCPs) were identified. SIR to develop cancer after treatment for CIN2-3 was 2.2 (CI 95% 1.89-2.50). Among these occurrences, 10 are in HPV related sites: 1 anus (SIR = 1.8; 0.04-10.0), 3 vagina (SIR = 12.4; 2.56-36.3), 1 vulva (SIR = 1.7; 0.04-9.59), 5 oropharynx (SIR = 8.5; 2.76-19.8). Significant risk has been also recorded for pulmonary (SIR = 3.1; 0.70-5.27) and bladder (SIR = 4.05; 1.10-10.56), with smoking as possible cofactor. We also found increased risk for breast (SIR = 2.4; 2.07-2.84) and ovarian cancers (SIR = 2.1; 1.13-3.49), probably due to an higher adherence to spontaneous and programmed screening programs.
Our study supports the hypothesis of an increased risk of HPV-related tumours for CIN treated patients, mostly for CIN3. It is conceivable the need of early diagnosis for these cancers in this higher-risk populations.
Clonal hematopoiesis of indeterminate potential (CHIP) is associated with increased risk of cancers and inflammation-related diseases. This phenomenon becomes common in persons aged ≥80 years, in ...whom the implications of CHIP are not well defined. We performed a mutational screening in 1794 persons aged ≥80 years and investigated the relationships between CHIP and associated pathologies. Mutations were observed in one-third of persons aged ≥80 years and were associated with reduced survival. Mutations in JAK2 and splicing genes, multiple mutations (DNMT3A, TET2, and ASXL1 with additional genetic lesions), and variant allele frequency ≥0.096 had positive predictive value for myeloid neoplasms. Combining mutation profiles with abnormalities in red blood cell indices improved the ability of myeloid neoplasm prediction. On this basis, we defined a predictive model that identifies 3 risk groups with different probabilities of developing myeloid neoplasms. Mutations in DNMT3A, TET2, ASXL1, or JAK2 were associated with coronary heart disease and rheumatoid arthritis. Cytopenia was common in persons aged ≥80 years, with the underlying cause remaining unexplained in 30% of cases. Among individuals with unexplained cytopenia, the presence of highly specific mutation patterns was associated with myelodysplastic-like phenotype and a probability of survival comparable to that of myeloid neoplasms. Accordingly, 7.5% of subjects aged ≥80 years with cytopenia had presumptive evidence of myeloid neoplasm. In summary, specific mutational patterns define different risk of developing myeloid neoplasms vs inflammatory-associated diseases in persons aged ≥80 years. In individuals with unexplained cytopenia, mutational status may identify those subjects with presumptive evidence of myeloid neoplasms.
•In the population aged ≥80 years, distinct mutational patterns define risk to develop myeloid neoplasms vs inflammatory-associated diseases.•In individuals with unexplained cytopenia, mutational status identifies subjects with presumptive evidence of myeloid neoplasms.
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This paper presents a series of compression tests performed on a variety of high performance lightweight cellular materials conventionally used in energy absorption applications. Compressive tests ...were performed over a range of strain rates with a universal testing machine and a single stage gas gun. Experimental results revealed a dependency of the mechanical properties on the polymeric precursor, density, infill topology and strain rates. The dynamic strength of the investigated materials was determined through a material parameter identification study via the finite element (FE) method. Numerical results matched well with the experimental results and revealed a substantial enhancement in the compressive strength of the tested material from quasi-static to dynamic loading regimes by as much as 87%. The strength of 3D printed polymers was superior with respect to the tested polymeric foams. On the other hand, polymeric foams showed higher efficiency and energy absorption ability.
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