To date, the burden of cancer among young adults has rarely been studied in depth. Our aim was to describe the scale and profile of cancer incidence and mortality worldwide among 20–39 year-olds, ...highlighting major patterns by age, sex, development level, and geographical region.
We did a population-based study to quantify the burden of young adult cancers worldwide. We defined young adult cancers as those occurring between the ages of 20 and 39 years because these individuals will have passed puberty and adolescence, but not yet experienced the effects of hormonal decline, immune response deterioration, or organ dysfunction associated with chronic health conditions. Global, regional, and country-specific (n=184) data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2012 among young adults were extracted in four 5-year bands from the International Agency for Research on Cancer's GLOBOCAN 2012 for all cancers combined and for 27 major types as defined by the International Classification of Disease, tenth revision. We report the number of new cancer cases and cancer-associated deaths overall and by sex alongside corresponding age-standardised rates (ASR) per 100 000 people per year. We also present results using four levels of the Human Development Index (HDI; low least developed, medium, high, and very high most developed), which is a composite indicator for socioeconomic development comprising life expectancy, education, and gross national income.
975 396 new cancer cases and 358 392 cancer-associated deaths occurred among young adults worldwide in 2012, which equated to an ASR of 43·3 new cancer cases per 100 000 people per year and 15·9 cancer-associated deaths per 100 000 people per year. The burden was disproportionally greater among women and the most common cancer types overall in terms of new cases were female breast cancer, cervical cancer, thyroid cancer, leukaemia, and colorectal cancer; in terms of deaths, female breast cancer, liver cancer, leukaemia, and cervical cancer were the main contributors. When assessed by development level and geographical region, the cancer profile varied substantially; generally, the burden of infection-associated cancers was greater in regions under transition. Cancer incidence was elevated in very high-HDI regions compared with low-HDI regions (ASR 64·5 vs 46·2 cancer cases per 100 000 people per year); however, the mortality burden was 3 times higher in low-HDI regions (ASR 25·4 vs 9·2 cancer-associated deaths per 100 000 people per year), reflecting differences in cancer profiles and inferior outcomes.
The global cancer burden among 20–39 year-olds differs from that seen in younger or older ages and varies substantially by age, sex, development level, and geographical region. Although the cancer burden is lower in this age group than that observed in older ages, the societal and economic effects remain great given the major effects of premature morbidity and mortality. Targeted surveillance, prevention, and treatment are needed to reduce the cancer burden in this underserved age group.
International Agency for Research on Cancer (IARC) and European Commission's FP-7 Marie Curie Actions–People–COFUND.
Background
Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is controversy about the ...treatment of these lesions and there are few studies that have synthesized what is known and provided meaningful information on treatment.
Questions/purposes
We performed a systematic review to address the following questions: (1) What is the best surgical approach for excising these lesions? (2) What is the age range, sex distribution, and presenting symptoms of subungual exostoses and which toe is most frequently affected? (3) What complications arise from treatment?
Methods
Two authors independently searched multiple databases (Medline, 1950–May 2013; Cochrane EBM database, and EMBASE, 1980–May 2013 provided by OVID; ACP Journal Club, 2003–May 2013; CINAHL by EBSCO, 1937–May 2013; and PubMed by NLM, 1940–May 2013), and key words were chosen to achieve a broad search strategy. We included studies on the management of toe exostoses with > 10 cases and we excluded studies that reported on upper extremity exostoses or osteochondromas. Demographic and treatment data were collected from each article by two independent authors and collated. A total of 124 abstracts were screened, and 116 articles were reviewed in full, of which 13 met the inclusion criteria.
Results
Complete marginal excision through a fish mouth incision protecting the nail led to a recurrence rate of 4% and satisfactory clinical results, defined as no requirement for postoperative intervention and a satisfactory clinical appearance in 73%. Most studies provided incomplete descriptions of specific surgical techniques used. Fifty-five percent of the patients were younger than 18 years of age. A history of toe trauma before diagnosis was present in approximately 30% of the cases. Delayed diagnosis occurred in approximately 10% of the cases and onychodystrophy occurred in more than 10%.
Conclusions
There is weak evidence to guide management of subungual exostosis. Adequate wound management postexcision aiming to minimize disruption to the nail bed and matrix may prevent onychodystrophy, which is a common complication of treatment.
BACKGROUND:Anterior vertebral body tethering (VBT) is an early treatment option for progressive scoliosis in pediatric patients, allowing for continued deformity correction during normal growth. We ...report postoperative radiographic and clinical outcomes for patients treated with VBT.
METHODS:This clinical and radiographic retrospective review of 31 consecutive patients included an analysis of preoperative, perioperative, and postoperative details, including the Lenke classification; Cobb angle measurements of the proximal thoracic, main thoracic, and lumbar curves; the sagittal profile; and skeletal maturity. Successful outcomes were defined by a residual curve of ≤30° in skeletally mature patients who did not undergo a posterior spinal fusion (PSF).
RESULTS:Of the 31 patients treated, 29 met the inclusion criteria, and 2 were lost to follow-up. The mean patient age (and standard deviation) at the time of the surgical procedure was 12.7 ± 1.5 years (range, 10.2 to 16.7 years), with most patients classified as Risser grade 0 or 1 (52%) and Sanders stage 3 (32%). A mean of 7.2 ± 1.4 vertebral levels were instrumented, with a minimum preoperative Cobb angle of 42°. At the latest follow-up, 27 patients had reached skeletal maturity (Sanders stage ≥7) and 20 patients exhibited a curve magnitude ≤30°, for a success rate of 74%. A suspected broken tether occurred at ≥1 level in 14 patients (48%). Two patients underwent PSF and 4 had tether revision. The overall revision rate was 21% (6 of 29).
CONCLUSIONS:This study shows the success and revision rates as well as the impact of a suspected broken tether on the procedural success of VBT. Despite our patient population being slightly more mature at the time of the surgical procedure compared with previous studies, we had a higher success rate and a lower revision rate. A PSF was avoided in 93% of patients, indicating that VBT may be a reliable treatment option for adolescent scoliosis in skeletally immature individuals.
LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Noise pollution caused by urbanization and industrial development must be effectively controlled to provide a pleasant living atmosphere. Different synthetic fiber materials have good acoustic ...performance, yet synthetic fiber materials have a high cost and have adverse effect on the environment. Natural fibers are a good alternative to synthetic fibers in terms of acoustic properties and they are also less expensive and have less environmental impact. Several factors affects the acoustic behavior of natural fiber reinforced polymer composites (NFRPCs). The present article focuses on the effect of different processing methods, reinforcement architecture, fiber diameter, laminate thickness and density on the acoustic performance of NFRPCs. Reinforcement architecture has been proved to be the best option in order to tailor the various acoustic properties of the composite laminates without even changing other physical properties. The challenges, future scope and potential applications of natural fibers in acoustic applications (home theaters, offices, cinema halls, automobiles, etc.) have also been discussed.
The article includes how the reinforcement architecture of the fiber affects the acoustic behavior of natural fiber reinforced polymer composites (NFRPCs). Also, the various processing methods of NFRPCs are highlighted along their effect on acoustic behavior. Various theoretical and experimental methods to evaluate acoustic properties are identified along with their advantages and disadvantages. Due to the promising properties of natural fibers and their composites, they are constantly being used in wide range of applications for various acoustic applications. In the coming years, the practical value of natural materials/fibers for acoustic applications will increase by developing different combinations of composites which can be used for acoustic applications.
Abstract
Background
Although adolescent and young adult (AYA) cancers represent a unique spectrum of malignancies, epidemiological studies of cancer incidence often group AYAs together with younger ...or older populations, obscuring patterns specific to this population.
Methods
We examined AYA cancer incidence trends in 41 countries over a 15-year period using the CI5plus database. Truncated age-standardized incidence rates were calculated and the annual percentage change was assessed, with statistical significance corresponding to a 95% confidence interval that does not include zero.
Results
From 1998 to 2012, the 41 included countries contributed a total of 1 846 588 cancer cases and 3.1 billion person-years among AYAs. Although statistically significant increases in the overall cancer burden were observed in 23 countries, the magnitude varied considerably, with the greatest increase in incidence observed in South Korea (annual percentage change2002–2012 = 8.5%, 95% confidence interval = 7.6% to 9.4%) due to thyroid cancer. Notable trends included sharp increases in the incidence of obesity-related malignancies among AYAs; indeed, statistically significant increases were observed among AYAs for 10 of 11 and 9 of 11 obesity-related cancer sites in the US and UK, respectively, with at least five obesity-related cancers statistically significantly increasing in Canada, Japan, South Korea, Australia, and the Netherlands. Other striking trends were noted for thyroid and testicular cancer, with statistically significantly increasing rates observed in 33 and 22 countries, respectively, whereas statistically significant declines in incidence were observed for smoking-related cancers, cervical cancer, and Kaposi sarcoma in many countries.
Conclusions
Our results highlight the future health-care needs related to treatment as well as the urgency for public health initiatives that can mitigate the increasing burden of cancer in AYAs.
Summary Investments in cancer control—prevention, detection, diagnosis, surgery, other treatment, and palliative care—are increasingly needed in low-income and particularly in middle-income ...countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Cancer (the third volume of nine in Disease Control Priorities , 3rd edition) developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of early breast cancer, cervical cancer, and selected childhood cancers; and widespread availability of palliative care, including opioids. These interventions would cost an additional US$20 billion per year worldwide, constituting 3% of total public spending on health in low-income and middle-income countries. With implementation of an appropriately tailored package, most countries could substantially reduce suffering and premature death from cancer before 2030, with even greater improvements in later decades.
A theoretical risk of "rebound" worsening of eosinophilic airway inflammation associated with negative outcomes has been suggested3 on the basis of in vitro observations that anti-IL-5 therapy is ...associated with upregulation of IL-5 synthesis by TH2 cells, upregulation of IL-5R expression by eosinophils, and persistence of preformed IL-5 in complex with the drug for a variable period of time after cessation of therapy.4 As part of a follow-up analysis, subjects completing a 12-month study of mepolizumab in refractory asthma1 were observed for 12 months with assessments every 3 months. The rise in exacerbations at 3 to 6 months after stopping mepolizumab was preceded by a rise in sputum and blood eosinophils, supporting suggestions that these events are related but have different time courses.5-8 The finding of increased asthma symptoms following cessation of mepolizumab was unexpected because symptoms were not modified significantly during the treatment period.1 However, mean symptom scores for subjects receiving mepolizumab were lower than for subjects in the placebo group at the end of the treatment phase of the study.
Asparaginase (ASNase) is an important component of acute lymphoblastic leukemia (ALL) treatment, but is often discontinued because of toxicity.
ASNase (
) substitution was approved in 2011 for ...allergic reactions.
has, however, been intermittently unavailable because of drug supply issues. The impact of
substitution or complete ASNase discontinuation is unknown.
Patients aged 1-30.99 years in frontline Children's Oncology Group trials for B-cell acute lymphoblastic leukemia between 2004 and 2011 (National Cancer Institute NCI standard risk SR: AALL0331; NCI high risk: AALL0232) were included. The number of prescribed pegaspargase (PEG-ASNase) doses varied by trial and strata. Maintenance therapy did not contain ASNase. Landmark analyses at maintenance compared disease-free survival (DFS) among those receiving all prescribed PEG-ASNase doses versus switching to
but receiving all doses versus not receiving all ASNase doses.
We included 5,195 AALL0331 and 3,001 AALL0232 patients. The cumulative incidence of PEG-ASNase discontinuation was 12.2% ± 4.6% in AALL0331 and 25.4% ± 0.8% in AALL0232. In multivariable analyses, NCI high-risk patients not receiving all prescribed ASNase doses had inferior DFS (hazard ratio HR, 1.5; 95% CI, 1.2 to 1.9;
= .002) compared with those receiving all prescribed PEG-ASNase doses. Patients with
substitution who completed subsequent courses were not at increased risk (HR, 1.1; 95% CI, 0.7 to 1.6;
= .69). NCI SR patients who discontinued ASNase were not at elevated risk (HR, 1.2; 95% CI, 0.9 to 1.6;
= .23), except when restricted to those with slow early response, who were prescribed more ASNase because of therapy intensification (HR, 1.7; 95% CI, 1.1 to 2.7;
= .03).
Discontinuation of ASNase doses is associated with inferior DFS in higher-risk patients. Our results illustrate the severe consequences of
shortages.
•A fractional model of RLW equation is considered.•The fractional RLW equation describes the shallow water waves in oceans.•The HPSTM is applied to obtain the solution of the mathematical model.•The ...derived results are presented in the form of graphs.•The numerical results obtained by using the HPSTM are in an excellent agreement with the exact solution.
In this work, we apply an efficient analytical algorithm namely homotopy perturbation Sumudu transform method (HPSTM) to find the exact and approximate solutions of linear and nonlinear time-fractional regularized long wave (RLW) equations. The RLW equations describe the nature of ion acoustic waves in plasma and shallow water waves in oceans. The derived results are very significant and imperative for explaining various physical phenomenons. The suggested method basically demonstrates how two efficient techniques, the Sumudu transform scheme and the homotopy perturbation technique can be integrated and applied to find exact and approximate solutions of linear and nonlinear time-fractional RLW equations. The nonlinear expressions can be simply managed by application of He's polynomials. The result shows that the HPSTM is very powerful, efficient, and simple and it eliminates the round-off errors. It has been observed that the proposed technique can be widely employed to examine other real world problems.
Summary
The development of tiny sensor nodes (SNs) has incarnated numerous applications in the field of wireless sensor networks (WSN). These devices became much popular in multidisciplinary research ...area such as the internet of things (IoT). However, the use of these devices has been restricted due to some constraints like SN energy, data aggregation, quality of service (QoS), reliability, SN deployment, scalability, energy consumption, and many more. Among all these constraints, we focus on SN energy, SN deployment, and energy consumption of the network. Because if the consumption of SN energy is less, network lifetime automatically increases. So, we propose active–passive node topology on deployed SNs which enhance the network lifetime. With the help of the proposed mechanism, the lifetime and stability have increased by 60% and 3%, respectively, as compared with directed diffusion protocol in Experiment 1. In another experiment, the lifetime has increased by 67%, 64%, and 62% as compared with LEACH, NEAP, and DREEP, respectively, in homogeneous environment. The proposed scheme also performed significant improvement in heterogeneous environment. The simulation performance shows that the proposed protocol increases the network lifetime and stability of the network.
An active–passive node topology on deployed Sensor nodes is proposed to enhance the network lifetime. The proposed scheme performed significant improvement in both homogeneous and heterogeneous environments. The simulations show that the proposed protocol increases the network lifetime and stability of the network.
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